Australia, the "allergy capital of the world," has launched a world-first free national treatment program for children with peanut allergies. The goal of the program is to safely build tolerance to peanuts, a troublesome nut, so children don't have to worry about life-threatening reactions.
Oral immunotherapy (OIT) has become an option for treating food allergies in children. It involves gradually increasing the child's daily intake of allergenic foods under the guidance of a doctor until a target maintenance dose is reached. This dose is then taken daily at home as a long-term treatment. The goal is to become desensitized to the allergen or, in the best case scenario, achieve what's called "sustained unresponsiveness" or remission.
Importantly, OIT is not a treatment, but rather helps your child's body adapt to foods that typically cause allergic reactions. Some food allergies disappear by the time a child is 12 months old, while others - especially peanut, tree nut, sesame and crustacean allergies - tend to be lifelong because they are unlikely to go away naturally. Therefore, it is even more important that Australia announces the world's first peanut OIT program for infants.
Professor Kirsten Perrett, director of the US National Center of Allergy Excellence (NACE), leader of the Murdoch Children's Research Institute (MCRI) Population Allergy Group, and leader of the ADAPTOIT project, said: "Oral immunotherapy is used in different ways around the world, making it difficult to assess its effectiveness, including long-term effects on children, their families and health systems."
Why was Australia chosen as the setting for this show? Because Australia is known as the "allergy capital of the world". It is estimated that 1 in 10 Australian children develop a food allergy within the first year of life, and 6 in 100 children develop a food allergy by the age of 10 years. However, Australian children are not alone; food allergies are on the rise around the world. The reasons for the increase in food allergies are unclear. Possible causes include changes in the mother's and baby's diet, as well as improved hygiene that reduces exposure to "good" bacteria, preventing the immune system from developing immunity. Particularly in Australia, an increase in vitamin D insufficiency has been linked to food allergies in children.
NACE is partnering with ten pediatric hospitals across five Australian states to launch the ADAPTOIT program for the first time. The program aims to use OIT to safely build up children's tolerance to peanuts and hopefully achieve remission, rather than requiring them to strictly avoid the problematic food. If successful, the program is likely to be rolled out to more hospitals and private clinics.
The federally funded ADAPTOIT program is available free of charge to children under one year old who are diagnosed with a peanut allergy and treated by an allergist at a participating hospital. For two years, they will take daily peanut powder at home on a carefully planned schedule and make regular visits to hospital allergy clinics.
Although peanut OIT has been shown to be safe, children enrolled in the program are given a plan of action for dealing with anaphylactic shock (a severe, life-threatening allergic reaction) and given epinephrine (epinephrine) syringes. In addition, parents will receive a comprehensive set of educational materials and access to the hospital's allergy specialists.
"In this Australia-wide model, food allergy testing at the end of treatment will help determine whether remission has been achieved," Perrett said. "We will then follow these children in routine clinical care for at least 12 months to help us assess acceptance, safety and effectiveness, quality of life and long-term efficacy. Ultimately, we hope to change the trajectory of allergic disease in Australia so that more children can attend school without the risk of a life-threatening peanut reaction."
Parents who sign their children up for the program need to know that OIT does not cure peanut allergies, is not necessarily suitable for everyone, and requires long-term persistence.
"OIT treatment takes time, and the program requires a long-term commitment from the family to give their children daily peanut powder at home and regular visits to the hospital allergy clinic," said Dr. Tim Brettig, a pediatric allergist and immunologist and medical director of the ADAPTOIT program. "It's important to remember Remember, OIT does not cure a disease, but by staying on treatment, it can improve your child's chances of safely eating certain food allergens, such as peanuts.
Australian parents who suspect their child is allergic to peanuts should first see their GP, who may refer the child to an allergist at a participating ADAPTOIT hospital. Then, once the allergy is confirmed and the child qualifies, treatment can begin.