As with most issues that center around food allergies this one also has many grey areas. It is incredibly exciting that new and life changing therapies for food allergy are around the corner. For those with food allergies and their families, the sooner, the better. With all the recent media excitement, expectations are high. Imagine not needing to accessorize with EpiPens and Twinjects. Imagine going into any restaurant anywhere and ordering anything that looks good. Imagine not having knots in your stomach after dropping your kid off at a party or play date. These are mind-blowing concepts to the parent of a child with food allergies.
There are several therapies for food allergies that are under investigation. One new approach is sublingual immunotherapy, where regularly increasing doses are given under the tongue until a specific dose is achieved and then given regularly. Oral immunotherapy, the furthest along and making headlines, also requires giving regularly increasing doses but by mouth until a maintenance dose is achieved. Both methods show great promise but can have side effects with build up, potential for loss of tolerance once regular dosing is discontinued, and may not offer complete protection. Others methods being investigated include peptide immunotherapy, the use of recombinant proteins, immunostimulatory proteins, plasmid DNA, plant derived remedies (FAHF-2), and anti-IgE.
Even once the studies have been completed, the therapies have been deemed safe and effective, the FDA has granted approval, insurance has agreed to cover, and the treatment is made available; only select patients with specific food allergies will meet criteria for treatment. Many of those with food allergies will continue to implement the same management strategies that they currently are.
We must all keep in mind that although there is great promise, this is the very beginning and in the next several years the great majority of those with food allergies will not have these treatments available. Until that time avoidance and emergency preparedness is key. We need to continue to maintain a high quality of life while at the same time remaining vigilant. It is imperative that parents and health care providers continue focus on education and empowerment when caring for children with food allergies.
Dr. Michael Pistiner is currently practicing allergy in Leominster, MA and recently completed his Allergy/Immunology fellowship at Children’s Hospital Boston, Harvard Medical School. He will be volunteering at Children’s Hospital Boston and working with the families of children with food allergies to help them manage their allergies. He has developed a special interest in food allergy, anaphylaxis, and in the management of food allergy in schools. He has seen first hand the critical importance of community wide education as his son has life threatening allergy to tree nuts.
Dr. Pistiner works with and speaks to pediatricians, nurses, support groups, and schools on food allergy and anaphylaxis management in various settings. Additionally, he has an interest in increasing food allergy awareness in restaurants and has been involved in food allergy advocacy in Massachusetts. He is committed to the use of practical food allergy education to replace fear and divisiveness with empowerment, confidence, and unity.