People with Peanut Allergies Could Get `Life Changing` Benefit from New Antibody Injection
6:22:47 2019-11-14 23
  • Researchers report that an antibody injection helped ease the reaction to peanut protein for 15 study participants with food allergies.
  • The researchers said all of the 15 participants were able to eat small amounts of peanuts 2 weeks after getting the immunotherapy treatment.
  • Experts say the new treatment would be “life changing” for people with food allergies if it’s proven safe and effective.

 

Immunotherapy could provide long-term protection against severe allergic reactions to peanuts, a new study suggests.

 

The small study reported that most people with severe peanut allergies were able to tolerate consumption of a nut’s worth of peanut protein 2 weeks after getting an antibody shot.

 

The research was published today in the journal JCI Insight.

 

The findings are preliminary and the study only involved 15 participants.

 

However, researchers from Stanford University reported that 73 percent of people with severe peanut allergies could eat a small amount of peanuts 2 weeks after getting the antibody treatment without ill effects.

 

By contrast, all members of a control group who received a placebo had an allergic reaction to eating the peanut protein.

 

Even 45 days after the shot, more than half of the treated patients could consume a nut-sized (375 milligram) serving of peanut protein without an allergic reaction while none of the control group could.

 

No participants experienced severe side effects.

 

 “We were surprised how long the effects of the treatment lasted,” said Kari Nadeau, MD, PhD, senior study author and a professor of medicine and pediatrics at Stanford.

 

A potential life changer

Experts see some far-reaching changes to people’s lives with a treatment like the one used in the study.

 

A vaccine that could limit or end allergic reactions to peanuts would be life changing for patients,” Kathleen Dass, MD, an allergist and immunologist in Oak Park, Illinois, told Healthline.

 

A very promising feature of this is that, unlike with desensitization, patients do not have to have exposure to peanut until it is safe to do so…” she said. “If this vaccine was approved for patients, it would be a life saving treatment option that I would implement as soon as I could.”

 

Punita Ponda, MD, assistant chief of the department of allergy and immunology at Northwell Health in Great Neck, New York, said the findings of the new study are exciting.

 

In the past, we just told people to avoid certain foods,” she told Healthline.

 

Ponda noted the small size of the study and the need for more research, but she added the placebo-controlled Stanford study was well designed with all participants confirmed to have food allergies through oral challenges.

 

An alternative to desensitization

Experts said the research demonstrates the potential for an alternative or adjunct to desensitization treatment, which is currently the only proven way to combat food allergies.

 

Desensitization involves giving people with allergies small amounts of their trigger foods, with amounts slowly increasing over a 6-month to 12-month course of treatment.

 

The lengthy treatment process must be done under medical supervision and allergic reactions can occur.

 

What’s great about this treatment as an option for food allergies is that people did not have to eat the food to get desensitized,” Nadeau told Healthline.

 

Although this is still in the experimental stages, we’re delivering on the hope of testing a drug that won’t be for one food allergy but for many, and for other allergic diseases, too.”

 

Nadeau and R. Sharon Chinthrajah, MD, a lead study author, treat allergy, asthma, and immunology patients at Stanford.

 

Food allergies, which can develop at any point in life, affect an estimated 32 million people in the United States.

 

After cow’s milk and eggs, peanut allergies are the third most common food allergy (and second most common among children). Peanut allergies affect about 1 in 50 children and 1 in 200 adults.

 

They’re also the most common food allergen to cause a fatal anaphylactic reaction.

 

Blocking the allergic reaction

The peanut antibody treatment called etokimab, developed by biotechnology company AnaptysBio, works by interfering with interleukin-33 (IL-33), an immune-signaling molecule that can trigger severe allergic reactions.

 

IL-33 also activates immunoglobin E (IgE), another antibody activated by the immune system that can cause symptoms ranging from mouth and throat itchiness and hives to breathing difficulties and sometimes fatal anaphylactic shock.

 

By inhibiting IL-33, we potentially inhibit features of all allergies, which is promising,” Nadeau said.

 

More therapies on the horizon

Biotechnology firm Aimmune Therapeutics is developing an immune desensitization therapy called Palforzia that appears to be the closest to winning approval from the U.S. Food and Drug Administration (FDA).

 

Dass noted that some clinicians are already providing oral sensitization therapy under controlled conditions, absent of FDA approval.

 

DBV Technologies, another biotech company, is developing a transdermal patch that delivers a daily measured dose through the skin. The company submitted its patch, Viaskin, to the FDA for approval in August.

 

There are no currently approved therapies, but we could have one or two by this time next year,” Liisa Bayko, a biotech industry analyst with JMP Securities, told Healthline.

 

Such desensitization treatments and immunotherapy such as etokimab could be used in combination, said Ponda, with IL-33 suppression used to block any dangerous allergic reaction arising from peanut exposure during desensitization.

 

Northwell Health is one of the study sites looking at combination therapy involving the immunotherapy drug dupilumab, developed by Regeneron Pharmaceuticals.

 

These treatments offer what Ponda termed “bite protection” — a barrier to a severe allergic reaction to accidental ingestion of a small amount of allergenic food.

 

More elusive is a therapy that would eliminate food allergies altogether.

 

As Ponda noted, only 20 percent of children with peanut allergies outgrow them naturally. About 10 percent outgrow allergies to tree nuts.

 

Gene therapy is another area of research for potential allergy treatments.

 

In 2016, researchers from Weill Cornell Medicine reported that gene therapy derived from omalizumab, an antibody that binds to and neutralizes IgE, prevented allergic reactions in lab mice.

 

The Stanford researchers are planning a larger follow-up study that will seek to identify biomarkers for people who can best benefit from the etokimab antibody treatment and also to fine tune the amount and timing of the therapy.

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