Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=227874
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Peanuts for allergy story

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Peanuts are among the most common childhood food allergens. Clinical trials conducted at the  Ann & Robert H. Lurie Children's Hospital of Chicago Research Center include children with severe peanut allergies.


Food for thought: Lurie researches new treatments of childhood food allergies

by Merrill D'Arezzo
Feb 12, 2014


Makhija

Northwestern University Feinberg School of Medicine

Dr. Melanie Makhija is a food allergy researcher At Lurie Children's Hospital.

“I am always frightened that Alyssa will have an allergic reaction. I just don’t think about it,” said Maria Keil, the mother of a child with severe food allergies.

“By the time Alyssa was diagnosed by an allergist, she was eight years old. The school nurse showed her where she would find ingredients on packaged items that indicated peanuts. While she was home and with me, I could control her environment. As she has been on her own she is conscientious about only eating peanut free items and she is assertive about speaking and asking about ingredients."

Some children’s food allergies are life-threatening and kids and parents have legitimate anxiety when children are not under parental supervision.

Right now, essentially, “we warn children to be careful of what they eat, give them an epinephrine pen and say good luck,” said Melanie Makhija, a food allergy researcher at the Ann & Robert H. Lurie Children’s Hospital of Chicago Research Center.

Striving to increase their knowledge, Lurie researchers are using new techniques to improve the lives of children with food allergies.

Hoping to someday create a less fearful world for children, is conducting clinical trials who’s results will hopefully help shape children’s food allergy treatment in the future.

The research center has been involved in four clinical trials since it was launched in 2011. The studies in which the center participates are all very new and no results have been presented.

All the studies at the center attempt to desensitize children’s bodies to their allergy and possibly create a tolerance for the allergy. Desensitization is like tricking a child’s body into tolerating the allergy. Tolerance would be actually curing the child of the allergy, explained Makhija

All the studies in which the center participates in are multicentered. A study that is multicentered has a better chance of excluding biases and is able to recruit enough patients to make the trial successful, Makhija said.

“Lurie Children’s is one of the only hospitals in the Midwest to be joining these studies,” Wendy Lankenau, a research nurse at the Division of Allergy and Immunology at the hospital, said.

Makhija said she “feels very privileged to be supported and have this new hospital” in which to conduct our research.

Oral immunotherapy is at the center of some of the trials. Oral immunotherapy is type of treatment in which participants are given small amounts of what they are allergic to everyday.

During the trial, food is administered in extremely small amounts along with a drug to help diminish allergic reactions the participant might experience. The hope is that one day if a child accidentally eats a small amount of their allergen they will not have a severe reaction Makhija said.

There are drawbacks to performing these trials as well, she conceded. All participants are required to take a “food challenge” before they are allowed to begin. The child must ingest what they are allergic to so researchers are able to mark a starting point. Children have had several reactions, including life – threatening anaphylactic shock during these challenges. The challenges always take place in secure environments within the hospital, and life-saving epinephrine and other treatments are readily available in case of an emergency.

Another drawback is the chance of side effects participants may experience while in the trial. These could include itching of the tongue, strange feelings in the throat, stomachaches and occasionally diarrhea.

Despite the side effects and risks, Makhija said it could be a “very promising treatment for food allergies,” one day and she is “excited about what is being researched.”

Researchers aren’t sure if oral immunotherapy treatments would be long-term solutions yet. There are doctors who are already offering oral immunotherapy treatment to their patients, but Makhija said she always tells her patients, “Until I know what is safe and I can tell you what the long-term risks are, I would not recommend it.”

The researchers at Lurie have had to turn away volunteers because of the interest the studies generate.

Parents have to agree on the clinical trials, but so do the children, ranging in age from 4 to 24 years old. The food challenge and overall nature of the trials are scary, but both children and parents desire to see advancement in the way childhood food allergies are treated. This desire for change is what draws them to participate in the trials.

Allergists don’t know what causes food allergies and why in only certain people. “I was drawn to the field because of the research that is being done,” Makhija said. She is hopeful that in the next decade or two there will be better treatments for food allergies.

Families of children with food allergies live in “constant fear.” If we could alleviate it, I think it would be nice for the families to not have to worry,” Makhija said.