Peanut tolerance study welcome but adrenaline pens more effective

Research into allergies which concludes that a tolerance to peanuts can be built up slowly has been welcomed by the country’s only expert in allergies among children.

However, Prof Jonathan Hourihane said community access to adrenaline pens would still be a more effective way to save lives.

The research showed that after six months of being given a very small but increasing amount of peanut protein, up to 90% of the children could eat five peanuts a day.

It means that parents and children would not need to be on constant high alert about accidentally eating foods contaminated by peanuts.

Such potentially fatal contamination is normally found at levels less than the 800mg of peanut protein that these children had built a tolerance to.

Up to 20,000 children in Ireland suffer from peanut allergy and before Christmas a 14-year-old girl, Emma Sloan, died on O’Connell St in Dublin after she ate a dish containing nuts. She had forgotten her EpiPen adrenaline injection which can stop the reaction.

Prof Hourihane said: “This research doesn’t demonstrate a long-term cure to the allergy. We don’t know if the reaction was just suppressed meaning that once the therapy stops, a reaction will resume.

“However it does show that quality of life improves markedly and it makes the allergy much more manageable.

“There is no way however that we could possibly take on that work in Ireland as we are not properly resourced here. However, if there was wider access to adrenaline injections in the community, there would be less children at risk of dying from peanuts.”

Study leader Dr Andrew Clark, from Cambridge University Hospitals, said the oral immunotherapy (OIT) treatment allowed children with all types of peanut allergy to eat large quantities of peanuts, well above the levels found in contaminated snacks and meals.

“Before treatment, children and their parents would check every food label and avoiding eating out in restaurants. Now most of the patients in the trial can safely eat at least five whole peanuts.”

One fifth of the children taking part in the study, published in the Lancet journal, reported an allergic reaction to the peanuts but all the responses were mild, with itching around the mouth the most common complaint.

However, co-author of the study, Dr Pamela Ewan, head of the allergy department at Cambridge University Hospitals, warned parents that OIT is not the kind of treatment people should try on their own at home. “It should only be done by medical professionals in specialist settings.”

Further research and alicensing review will be required before peanut immunotherapy can become generally available to the public, which could take several years.

A peanut allergy is potentially fatal as it can lead to anaphylactic shock which can stop a person breathing.

The STOP II trial, the largest of its kind worldwide, involved 99 children aged seven to 16.