With all of the advances in medicine, surely there must be something exciting in the field of food allergy research. I invited Dr. Scott Sicherer, a food allergy expert, for a Q and A on the topic.
Kosher with Food Allergies Interview Series
Interview #2 Food Allergy Research Trends, Dr. Scott Sicherer
Interview #2 Food Allergy Research Trends, Dr. Scott Sicherer
What are some of the food allergy research studies currently underway?
This is an exciting time for food allergy research because many ideas have gone from the laboratory into trials in people. At the Jaffe Food Allergy Institute at Mount Sinai in New York, we have or are undertaking a number of studies, many in collaboration with other institutions across the US. For example, the most actively studied approach is called oral immunotherapy, when the trigger food is given gradually over weeks and months under close medical supervision. This approach has been evaluated for many different foods. It seems that many people can experience at least an improvement in the amount of food that can be eaten before symptoms occur and some, a minority, may even experience, after long periods of treatment, a “cure” where they are able to eat the food without being on the treatment. However, DO NOT TRY THIS AT HOME because almost everyone has allergic reactions, sometimes severe, and we have a lot more to do to determine the safety and effectiveness of this approach. Variations on this idea include using even smaller doses under the tongue or giving the therapy along with treatments that suppress allergic reactions. Other approaches include “vaccines” made from the food but altered in a way to try to reduce the risk of allergic reactions from the treatment itself. We also have been testing a specially formulated herbal treatment based on Traditional Chinese medicine, which showed promise in improving food allergy in mice. Other treatments under study include using medications such as Xolair (which is an asthma medication that is injected and inactivates a protein responsible for allergy). Additional approaches that people have been trying in studies include probiotics (a type of “good” bacteria) and parasite eggs (a type that does not cause illness in people) to try to improve immune responses-there are no clear positive results thus far from these studies.
How does a person participate in research and what is involved?
Each study has specific criteria (age, type of allergy, etc) that must be fulfilled. Usually, there are various tests to be sure the person is healthy enough to participate, some type of test is included to determine how sensitive the person is to the food or foods. Once qualified to participate, the treatment (or placebo) is given for a period of time before retesting sensitivity to the food. In treatment trials, a placebo treatment is included to be sure comparisons are made in a meaningful way. People on false treatment (placebo) usually have some improvement just because of the “placebo effect” of expecting improvement. Each study has specifics that are related to the exact nature of the study. Research studies are regulated in a variety of ways to maximize safety for participants. Being a participant can be empowering for the individual and certainly helps everyone with food allergy since this is the only way to evaluate treatments. Of course, there could be a direct benefit to the participant, but since all studies are testing something that is not already proven, you cannot assume there will be a benefit. You should talk to your doctor about trials.You can look at www.clinicaltrials.gov and search under food allergy to check for local trials. You can register for studies at www.researchmatch.org. If you can travel to the Jaffe Food Allergy Institute in New York City, you can ask to be included in our research email list by emailing your request to foodallergyresearch@mssm.
How long do you think we have until there is a cure?
We are not at a loss for ideas and we have various possibilities being researched in the laboratory and in people. The main issue regarding timing is doing the clinical trials because major studies can each take a few years to complete. The biggest barriers to moving studies forward are finding participants and having funds to do the studies. Being a participant is a commitment and it is getting harder to find people willing to donate their time, and this definitely slows progress. We could be doing more to find alternative treatments, but funding is often insufficient. The treatment that is probably closest to more widespread use is oral immunotherapy, but trials to better define the safety and efficacy so that the approach, if successful enough, can be federally approved are still years away. It is already clear that a majority do not get a cure at least after a few years of treatment and so alternatives must also be researched. It is hard to predict when better therapies will be found, but having more funds and participants would speed the process.
Professor of Pediatrics
Mount Sinai School of MedicineJaffe Food Allergy Institute
New York, NY 212-241-5548
Scott H. Sicherer, MD is a professor of pediatrics at the Mount Sinai School of Medicine and a researcher in the Jaffe Food Allergy Institute at Mount Sinai. He is Chief of the Division of Pediatric Allergy and Immunology. He has published over 130 articles in scientific journals and has authored numerous book chapters in major pediatric and allergy textbooks. He has authored several books on food allergy including Understanding and Managing Your Child’s Food Allergies. Dr. Sicherer has been consistently recognized as a “Top Doctor” by Castle-Connolly/New York Magazine, and been recognized by U.S. News and World Report as being among the top 1% of pediatric allergists.
