An experimental toothpaste aims to treat peanut allergies

Peanut allergies are an ever-increasing social, clinical, and financial burden for society in developed countries. Due to the lack of treatments, avoidance continues to be the standard of care, resulting in economic and emotional burdens for patients and caregivers. Peanut allergy concerns have been compounded in the face of the global COVID-19 pandemic.

Intrommune Therapeutics, a New York City–based company,
has started trials of an experimental toothpaste on a small group of people allergic to peanuts. The hope is that by being regularly exposed to small doses of the allergen, these people will build up and maintain a natural defense against it.

Oral immunotherapy, one of the current popular treatments against food allergies, requires users to ingest daily doses of the allergen in their daily meals, which can sometimes trigger relatively strong allergic reactions.

Another treatment, sublingual immunotherapy, is a gentler method that delivers microdoses of the allergen in the form of drops placed beneath the tongue. However, this method can more easily be left out of a daily routine, and it’s believed the best immune cells to target for such allergens are in our cheeks, not under our tongue, say the experts working on the toothpaste therapy.

So, using toothpaste with embedded allergens more quickly and easily targets the immune cells in our cheeks. And as brushing teeth is already a regular daily habit, it’s hard to forget to carry out this therapy, which is also offered in smaller doses, thus not triggering strong allergic reactions.

While there is support for the toothpaste concept, some Allergists worry about dose control and safety. When a patient’s gums are sore and inflamed — for example, after dental work or losing a tooth — allergens may have direct access to the bloodstream, which increases the risk of systemic allergic reactions.

Food allergies leave parents living in fear

Parents of children with food allergies face significant worry, severe anxiety and post-traumatic stress – according to new research from the University of East Anglia.

Between six and eight per cent of children suffer a food allergy – with eggs, milk, and peanuts being the most common causes. They can cause vomiting, cramps, hives, swelling, eczema, breathing problems and in severe cases anaphylactic shock, which can lead to hospitalisation or death.

A new study published finds that more than 80 per cent of parents face ‘significant worry’ about their child’s food allergy, while 42 per cent met the clinical cut-off for post-traumatic stress symptoms (PTSS) and 39 per cent reported moderate to extremely severe anxiety.

Parents whose children have had to have an adrenaline auto-injector (for example an Epipen) administered were seven times more likely to experience PTSS.

Judith Young, from UEA’s Norwich Medical School and Addenbrooke’s Hospital, noticed in her work as an Honorary Consultant Clinical Psychologist that parents were describing psychological distress related to their child’s allergy, but that there was little research into this.

Dr Kate Roberts carried out the study as part of her doctoral thesis at UEA, in collaboration with Judith Young,

Dr Alex Brightwell from Norfolk and Norwich University Hospitals NHS Foundation Trust and Prof Richard Meiser-Stedman, from UEA’s Norwich Medical School.

Dr Roberts said: “Caring for a child with a food allergy can be really challenging – not least because they can be exposed to the foods they are allergic to, even with very careful management.

“We wanted to see how the parents of children with food allergies were affected by anxiety, worry and PTSS. And we also evaluated whether the level of anxiety and stress experienced was linked to factors such as the severity of the child’s allergy.”

A total of 105 parents of children with medically diagnosed food allergies completed online questionnaires about their experiences.

Around half of the children had been rushed to hospital at least once because of an allergic reaction.

As well as considering the level of the child’s allergy, the team also looked at the parents’ intolerance of uncertainty – how they manage unforeseen events, like the fact that they cannot completely control their child’s exposure to food they’re allergic to.

They also assessed the parents’ ‘self efficacy’ – their confidence in allergy management.

Dr Roberts, who now works at Cambridgeshire Community Services NHS Trust and the Queen Elizabeth Hospital King’s Lynn, said: “We found that a large proportion of the parents – 81 per cent – reported clinically significant worry and 42 per cent reported significant trauma symptoms related to their child’s food allergy.

“Parents who reported their child to have had an adrenaline auto-injector (AAI) administered, were around seven times more likely to report clinically significant PTSS.

“Greater intolerance of uncertainty and lower food allergy self-efficacy were associated with poorer psychological outcomes. But we found mixed results for the relationship between allergy severity and parent mental health, with PTSS observed in parents of children with both life-threatening and milder allergies.

“This really highlights the need for greater awareness about the mental health problems that parents of children with food allergies may be experiencing.

“Knowing which factors could predict different psychological outcomes is important because it could help identify those parents who may be struggling with their mental health and help them overcome some of the problems they may be experiencing,” she added.

Dr Alex Brightwell, Consultant Paediatrician, said: “I am delighted to have had the opportunity to work with UEA in this important area to contribute to an emerging body of evidence and ongoing research about the impact of food allergies on families. Anxiety and worry about having a child with food allergies is something we are seeing on a day to day basis. We are looking forward to working with UEA on further research to develop tools to support families affected by food allergy.”

UCLA study: using nanoparticle technology shows promising results for treating severe allergies

UCLA scientists may have developed a long-term treatment for severe food allergies.
The technology uses a nanoparticle — a particle to deliver proteins to specific cells in the liver. Those proteins may trigger an allergic response in other organs in the body, but in the liver, they cause the targeted cells to activate a tolerant immune response that switches the allergic response off.
“The researchers’ therapy takes advantage of the liver’s ability to stop the immune system from entering an allergic reaction”, said Tian Xia, an associate professor of medicine and co-author of the study. “The liver frequently interacts with foreign proteins that people eat, so it has a natural immune tolerance,” he added.

The treatment uses injections into the bloodstream to deliver allergen particles to the liver so that it can perform the process it undergoes commonly when encountering foreign proteins.
Further experimentation must be done to determine how long the therapy’s effect could last it is hoped that the therapy could provide resistance against allergies for a lifetime. If not, the treatment could be administered on an interval basis, around weeks or months apart.
Currently, the treatment is in the preclinical phase. The team is testing its therapy on animals and will submit documentation to the Food and Drug Administration to move on to human clinical trials.

Teen recognized for his heroic actions that helped save his mother after she fainted while driving due to unknown peanut allergy

The Cicero Police Department recently awarded 13-year-old Nathan Bustin the CPD Life Saving Award for his actions after his mother suffered a medical crisis while driving.

54-year-old Lisa Bustin from Clay, New York passed out after developing a peanut allergy.

Her son Nathan watched his mother faint behind the wheel and quickly took it after she lost consciousness. Police believe his heroic actions likely helped prevent a deadly car crash or serious injuries.

Lisa explained that she had taken her son to ice hockey practice. While waiting, she was hungry and decided to eat peanuts from a jar that she found in the car.

“I’m not a big peanut eater,” she said. “I almost never do. Just that day they were in the car and I happened to be hungry and I just didn’t think anything of it because I didn’t ever have a peanut allergy.”

While driving home, she said that her feet and hands started to tingle, and her cheeks felt like they were on fire. Suddenly, Nathan saw his mother roll down the window and instantly knew something was wrong.

“ Her eyes rolled up and her head went back to the headrest,” he said. “As soon as she went unconscious, her hands just dropped and totally relaxed.”

Nathan immediately grabbed the steering wheel, but was unable to reach the brake or gas pedals in order to stop the vehicle. Upon taking control of the vehicle, Nathan was then able to grab his mother’s phone and call 911 to report his mother had passed out.

Nathan recalls that the car was going slow at first, but then Lisa’s foot was on the gas pedal, and the vehicle accelerated to about 40 miles an hour but their car finally stopped after it hit a slow-moving truck. Amazingly, no one was injured and Lisa was transported to the hospital.

Doctors have informed Lisa that the cause of her passing out was an allergic reaction to peanuts; which she says she was not aware of.

The Cicero Police Department honored Nathan by awarding him the CPD Life Saving Award. If not for Nathan’s quick thinking, the outcome of this incident could have been much different.

Adult-onset food allergies are considered increasingly common, with a recent study finding as many as 12 million Americans had developed a food allergy in adulthood.

Study To Find Out What’s Causing Allergic Reactions To Covid-19 Vaccines

A new study is set to launch looking at why a few rare cases of people have suffered from severe allergic reactions shortly after receiving mRNA-based COVID-19 vaccine shots.

The U.S. National Institute of Allergy and Infectious Diseases (NIAID) is planning to launch the multi-center study working with the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA) and vaccine makers.

The aim of the research is to find out whether people with allergies are at any higher risk of a reaction than those without allergies. Researches also hope to identify the component of the vaccines most likely to be responsible for these potentially life-threatening incidents, known as anaphylaxis.

The study is expected to include several hundred people who have a history of severe allergic reactions to foods, medications or insect stings.
The vaccine will be injected under close medical supervision and set to begin in a matter of weeks.

Study: Nearly one in five parents of food-allergic children are bullied

New research shows that food allergy bullying is not just a problem for food-allergic kids but also their parents too.

“We know children are often bullied about their food allergies,” says Dannielle Brown, MHS, lead author of the study. “What we weren’t aware of was how many parents are bullied by multiple sources. Of the 252 parents or guardians we surveyed, more than 17% said they had been bullied.”

Parents of children 4-17 years (school-age children) in the survey found it was helpful to take action to stop the bullying. 13% of parents/guardians spoke with their child, 7% spoke with the offender or the offender’s parent, 17% spoke with a teacher and 15% spoke with a principal or administrator. Almost 50% of those who did something to stop food allergy bullying said it was helpful.

Another important finding in the survey was that while there were no significant differences in the percentages of Black and white children who were bullied around food allergies.

“No child or their parent should be bullied because of their food allergies,” says food allergy researcher Ruchi Gupta, MD, MPH, ACAAI member and one of the lead researchers on the study. “Having a food allergy puts tremendous stress on the entire family and any form of bullying makes life that much harder.”

Study finds antibiotics before age 2 associated with childhood health issues

In a retrospective case study, Mayo Clinic researchers have found that antibiotics administered to children younger than 2 are associated with several ongoing illnesses or conditions, ranging from allergies to obesity. The findings appear in Mayo Clinic Proceedings.

Using health record data from the Rochester Epidemiology Project, a population-based research collaboration in Minnesota and Wisconsin, researchers analyzed data from over 14,500 children. About 70% of the children had received at least one treatment with antibiotics for illness before age 2. Children receiving multiple antibiotic treatments were more likely to have multiple illnesses or conditions later in childhood.

Types and frequency of illness varied depending on age, type of medication, dose and number of doses. There also were some differences between boys and girls. Conditions associated with early use of antibiotics included asthma, allergic rhinitis, weight issues and obesity, food allergies, attention deficit hyperactivity disorder, celiac disease, and atopic dermatitis. The authors speculate that even though antibiotics may only transiently affect the microbiome, the collection of microbes in the body, this may have long-term health consequences.

“We want to emphasize that this study shows association ,not causation of these conditions,” says Nathan LeBrasseur, Ph.D., a researcher at Mayo Clinic’s Robert and Arlene Kogod Center on Aging and the study’s senior author. “These findings offer the opportunity to target future research to determine more reliable and safer approaches to timing, dosing and types of antibiotics for children in this age group.”

While recent data show an increase in some of the childhood conditions involved in the study, experts are not sure why. Other than the issue of multidrug resistance, antibiotics have been presumed safe by most pediatricians.

Researchers also say the ultimate goal is to provide practical guidelines for physicians on the safest way to use antibiotics early in life.

The Teal Pumpkin Project Continues This Halloween

Although Halloween looks different this year due to the COVID-19 Pandemic, The Teal Pumpkin Project continues in 2020. The Teal Pumpkin Project initiative aims to raise awareness surrounding food allergies by making Halloween safer and more inclusive for all trick-or-treaters while remaining mindful of the challenges presented by the ongoing COVID-19 pandemic.

“As families determine how to safely celebrate Halloween this year, FARE is reminding parents to make these celebrations as inclusive as possible for all children, including those with food allergies,” said Lisa Gable, chief executive officer of FARE.

The Teal Pumpkin Project encourages participants to place a teal pumpkin in front of their homes to show they have non-food treats available for children with food allergies or necessary dietary restrictions. Many popular Halloween candies contain nuts, milk, egg, soy, wheat or sesame, which are among the most common allergens. Additionally, many miniature candy items do not have labels and may be formulated or manufactured differently than full-sized candies of the same brand, making it difficult to determine whether these items are safe.  To learn more about the Teal Pumpkin Project, visit www.tealpumpkinproject.org.

Study: Spike in new nut anaphylaxis in children at Halloween and Easter

A new study looking at the link between peanut and tree-nut anaphylaxis in children and holidays found spikes at Halloween and Easter. The study, published in CMAJ (Canadian Medical Association Journal) found that most were previously unknown allergies, calling for increased awareness http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200034.

“Identifying certain times associated with an increased risk of anaphylaxis could help to raise community awareness, support and vigilance,” write Dr. Melanie Leung, 4th-year medical student at McGill University and Dr. Moshe Ben-Shoshan, McGill University Health Centre, Montreal, Quebec, with coauthors. “This information would identify the best timing for public awareness campaigns to prevent allergic reactions.”

Researchers compared anaphylaxis at Halloween, Easter, Christmas, Diwali, Chinese New Year and Eid al-Adha.

The study included 1390 patients visiting participating pediatric emergency departments between 2011 and 2020 in 4 Canadian provinces: Quebec, Ontario, Newfoundland and Labrador, and British Columbia. The median age of patients was 5.4 years and 62% were boys.

For peanut-triggered anaphylaxis, there was an 85% increase in daily average cases during Halloween and a 60% increase during Easter compared with the rest of the year. For anaphylaxis triggered by unknown nuts, there was a 70% increase during Halloween and Easter compared with the rest of the year. However, the researchers did not find an increase at Christmas, Diwali, Chinese New Year or Eid al-Adha.

“The difference in the anaphylaxis incidence among holidays may have been due to the social setting in which each holiday takes place,” write the authors. “At Halloween and Easter, children often receive candies and other treats from people who may be unaware of their allergies. The absence of such an association at Christmas may be because Christmas is a more intimate celebration among family members and close friends, who are more vigilant regarding allergen exposure.”

Canadian labelling may also be a factor, as individual packages of candies and snacks, which are exempt from labelling requirements listing ingredients, are popular at Halloween and Easter.

The authors suggest education and awareness may help reduce the risk of anaphylaxis.

“Our findings suggest that educational tools to increase vigilance regarding the presence of potential allergens is required among children with food allergies, their families and lay people interacting with children who have food allergies. Newer strategies targeting intervals associated with high anaphylaxis risk are required.”

Therapy Helps Children with Food Allergies Manage Severe Anxiety

Imagine a young girl with a peanut allergy, so stricken by fear of anaphylaxis that she no longer takes part in everyday activities many children take for granted. She’s stopped playing with her siblings, worried that residue from their peanut butter crackers may trigger an allergic reaction. She obsessively washes her hands to make sure there is no trace of peanut on them. She worries that every stomachache could mean she accidently ate something she was allergic to.

This story is becoming more familiar to families across the country. While most children with food allergies maintain a healthy level of caution, there is a small percentage whose anxiety is excessive and impairing. The hallmark of excessive anxiety is going to extreme, medically unnecessary lengths to avoid the allergen, such as no longer visiting extended family or refusing to eat any allergen-free food that isn’t familiar. While these coping mechanisms may relieve anxiety in the short term, they may ultimately cause more harm by negatively reinforcing the idea that the world is a dangerous place and that children are helpless to keep themselves safe.

Now, Children’s Hospital of Philadelphia (CHOP) has launched the Food Allergy Bravery (FAB) Clinic to help children with a phobia of anaphylaxis. This revolutionary clinic, housed within the Food Allergy Center, is the first in the world to bring together psychologists and food allergy experts to treat food allergic children with severe phobia of anaphylaxis.

The three Founders of the FAB Clinic published a set of best practices in the Journal of Allergy and Clinical Immunology, providing guidance to allergists and pediatricians on how to address allergy-related phobias through Cognitive Behavioral Therapy (CBT).

“CBT works by gradually encouraging anxious children to take part in ‘brave practices,’ like eating with the rest of their family, playing with siblings, and trying new foods that don’t contain allergens,” said Katherine Dahlsgaard, PhD, ABPP, Director of the FAB Clinic at CHOP. “As a child’s confidence grows, we gradually introduce them to more challenging brave practices. This could include sitting in the same room with the food they’re allergic to, or even touching the food and then washing their hands thoroughly. The aim is to help children realize, through safe, structured practices in the FAB Clinic, that the world is much safer than they think and that they are capable of keeping themselves safe within it.”

The FAB clinic enthusiastically employs the help of family members, coaching parents or caregivers to repeat brave practices at home.

“We want these children and their families to know they’re safe and capable,” said Dr. Dahlsgaard. “Our ultimate goal is to equip families with practical skills and confidence via focused treatment sessions, so that their child can safely navigate a world that can’t always be allergen-free.”

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