“Buy me some legumes and Cracker Jack,
I don’t care if I never get back…”
The 1908 unofficial anthem of the game of baseball just isn’t the same without peanuts.
Yet, ever-growing numbers of Americans are diagnosed with an allergy to the salty little snacks every year.
Now, a new study out of Australia suggests a possible path to a solution.
The study, published in The Lancet Child & Adolescent Health journal, does not purport cure.
Instead, it focuses on an immune-based therapy that helped children allergic to peanuts eat them without reactions for four years.
The research follows up on some of the 56 children who were enrolled in an earlier study of an immunotherapy treatment that combined probiotics with small doses of peanuts.
The dosages were designed to gradually train the children’s immune systems not to reject the nuts as a foreign body but to accept the peanut allergen.
The results have intrigued specialists in the field.
Speaking for the Allergy & Asthma Network, Dr. Purvi Parikh, an allergist and immunologist in New York, told Healthline in an interview, “This is a new way to look at what is often a debilitating allergy. This isn’t the end-all, but offers a glimmer of hope.”
“There’s a lot we need to understand,” Parikh added.
How the treatment works
Scientists involved in previous studies showed that exposing children to peanuts in small amounts can reduce their allergies, preventing such serious reactions as life-threatening anaphylactic shock.
The Australian team decided to improve their odds of success by adding probiotics.
Probiotics are foods or supplements that contain “friendly” bacteria. They are supposed to help colonize our guts with health-boosting microorganisms.
The idea is that the probiotics improve the digestive system’s ability to tolerate the peanuts without an immune reaction.
The result of the original study showed 82 percent of those receiving the combination therapy exhibited a significantly reduced allergic reaction to peanuts.
That compares to 4 percent of children who did not get treated.
The follow-up study tracked the children for four years after treatment. Researchers found that 67 percent of the children who were treated were able to eat peanuts without ill effects. Only 4 percent of those in the control group had such a favorable response.
But — and it’s a big but — the study’s size “is a limitation,” Parikh said.
Fifty-six is not a sufficient number of children from which to draw conclusions. That’s fewer than 20 children who showed positive results.
“We need bigger studies and more diverse ones, too,” she said.
Factors to consider
Before anyone will talk about a cure, there are a lot of factors that need to be investigated.
Parikh wondered if the results would hold true outside of Australia.
“And we should test people of different income levels,” she said.
Parikh noted that allergy rates are much higher in the West and in industrialized societies.
The reason, she suggested, is what’s known as the hygiene hypothesis. This theory focuses on asthma, environment, and food.
It states that a lack of early childhood exposure to infectious agents and microorganisms leaves people vulnerable to more allergies. In other words, we’ve cleaned ourselves into more illness.
Another area that requires more investigation is the usefulness of the probiotics themselves.
“We need a study with three groups,” said Dr. Brian Schroer, an allergist and immunologist at the Cleveland Clinics Children’s Hospital, in an interview with Healthline.
A three-pronged study would involve one group receiving both the allergen and the probiotic, a second group receiving just the allergen, and the third segment serving as a control group, receiving neither.
The results at present do not justify a change in treatment, he said.
That said, Schroer added, “Future treatment probably will involve oral immunotherapy and probiotics.”
Where we go from here
Parikh said that even a partial improvement could have important ramifications for allergy sufferers.
“For instance, if their sensitivity lessens, perhaps we could ease school rules,” she said.
Because some children are at risk of a fatal attack, many schools ban peanuts from the premises, including in classmates’ lunches.
Other studies have suggested that infancy is the best time to desensitize children.
A panel of experts from the NIH’s National Institute of Allergy and Infectious Diseases has issued adjusted clinical guidelines on the prevention of peanut allergies in children. The old guidelines advised keeping at-risk babies away from known or suspected allergens.
Now, some allergy specialists and parents are being encouraged to give tiny amounts of peanut-containing foods (extract or powder) to their infants when they are as young as 4 to 6 months old.
There appears to be “a window of time in which the body is more likely to tolerate a food than react to it,” Dr. Matthew Greenhawt, a food allergy expert, told The New York Times.
Greenhawt is a specialist in pediatrics and allergy and immunology, and is on the faculty of the University of Colorado School of Medicine.
Where probiotics fit into this remains to be seen. And will this method work on older people?
“That’s what science is for, answering questions,” Schroer said.