Ask the Allergist

by Dr. Jay Lieberman, FAAM's Medical Advisor

Q:

Hi, my 23 month old son was diagnosed with anaphylaxis to peanuts at 21 months along with an allergy to cat and dog dander. With all the new research coming out lately about allergies I would like to know if it is possible to reverse allergies, specifically his peanut allergy, and if so what steps would we take? Thank you for taking the time to respond.

A:

Thank you for your excellent question.
As of now, there is no known “cure” for food allergies. Currently, the only form of treatment available that is being studied is allergen-specific immunotherapy.  This is where the allergic patient is exposed to the allergen in some form (e.g. swallowed, under the tongue, or through the skin via a patch) over time.  Typically the allergen is given initially in very small quantities and increased over time (not the case with the patch). This is also known as desensitization and utilizes the same concept as allergy shots.  The idea is that slow exposure over time, perhaps using various routes, will switch the patient’s immune response to that allergen.

Currently, there is no FDA-approved form of this treatment.  However, there are many ongoing studies of various forms of immunotherapy for food allergies, with the hopes that one day we will have approved, effective treatments for food allergies.

To the best of our knowledge to date, these treatments are effective in desensitizing the patient to the allergen, or as you state, reversing the allergy.  Studies of most forms of food-immunotherapy suggest that it works in the majority of patients as long as they can tolerate the treatment (many patients have had side effects to the treatment such as allergic reactions or stomach problems that do not allow them to continue the treatment).  This means that as long as the patient continues to be exposed to the allergen on a regular basis, they can tolerate more of the allergen than before the treatments started.  However, this does not necessarily mean the allergy is “cured”.  A few studies have shown that some patients continued to be desensitized to the allergen even months after stopping the therapy.  However, this has only been shown in some patients and should not (at least at this time) be considered the expected result of immunotherapy.

As mentioned, there are ongoing studies around the world examining these treatments to various foods (peanut being the most frequently studied).  If you are interested in learning more about these studies, I recommend visiting ClinicalTrials, which is a website sponsored by the National Institutes of Health and should list all ongoing studies, searchable by condition, if they are enrolling subjects, and sites of enrollment.

​There are some private practices that offer this treatment.  To my knowledge, there are not any in the Memphis area.  Whether this service should be offered through a non-research protocol, at a regular allergist’s office has been debated at the national stage with strong feelings on both sides.  If this is an interest of yours, I unfortunately cannot give any recommendations regarding this. ​