There is presently no cure for food allergy. Currently, healthcare providers can manage patients’ food allergies by encouraging them to avoid foods that may cause an allergic reaction and by treating severe reactions when they arise. But the rate of food allergic reactions are high—about one each year for allergic children, according to a 2012 NIAID-funded study.
To address this high rate of events, scientists are working to develop immunotherapy approaches to prevent and treat food allergy. Immunotherapy involves exposing the immune system to an allergen in a controlled way in order to eventually lessen the immune response to that allergen. This basic approach can take many forms, all of which are experimental. Immunotherapy is not currently approved by the Food and Drug Administration for use to treat food allergy. However, research to investigate different approaches to immunotherapy in food allergy is ongoing.
NIAID-funded researchers have implemented several clinical trials to assess the effectiveness of different forms of immunotherapy for the treatment of food allergy. View all NIAID-sponsored clinical studies on immunotherapy for food allergy.
Oral immunotherapy, or OIT, is being tested in several NIAID-funded clinical trials to evaluate the role of OIT in treating and managing food allergy. OIT involves eating small doses of the food that causes the allergy—usually in the form of a powder mixed with a harmless food—and gradually increasing these doses every day. A 2012 study from the NIAID-funded Consortium of Food Allergy Research (CoFAR) suggested that egg OIT can benefit children with egg allergy. Most of the study participants could be safely exposed to egg while on egg OIT, and some were able to safely eat egg after stopping OIT. Most of the study participants could be safely exposed to egg while on egg OIT, and some were able to safely eat egg after stopping OIT.
Another ongoing NIAD-funded study called MAP-X is testing whether using an additional medication, an injectable antibody called omalizumab, taken during OIT could improve the safety of the therapy or make it more effective in individuals with allergies to several different foods. Omalizumab blocks IgE activity, so researchers believe the medication may reduce allergic reactions during OIT. See more information on this ongoing omalizumab-aided clinical trial for multi food allergic patients.
Other OIT trials include the IMPACT study, conducted by the NIAID-sponsored Immune Tolerance Network. In this ongoing study, investigators are testing the ability of peanut OIT to elicit tolerance to peanut among young children with peanut allergy. See more information about the IMPACT peanut allergy study here.
In small clinical trials, OIT has been shown to provide some benefits to patients with milk, egg, or peanut allergies. However, many issues still need to be addressed before this therapy can be broadly applied to food allergy sufferers. Researchers are working to improve the safety and effectiveness of OIT for a wider variety of food allergies.
In epicutaneous immunotherapy, or EPIT, an allergen is delivered to the skin’s surface by a wearable patch. The NIAID-funded Consortium of Food Allergy Research recently completed a study to evaluate the safety and efficacy of EPIT for peanut allergy. The therapy enabled recipients of the patch to tolerate larger amounts of peanut in a blinded oral food challenge after one year of treatment compared to the amounts they could tolerate in an oral food challenge at the start of the study. The patch was associated with skin reactions, but these were mostly mild, local reactions that did not interfere with use. Patients are now receiving longer term administration of the patch and follow-up within the study. See more information about this clinical trial on epicutaneous immunotherapy for peanut allergy.
For several allergy problems, like hay fever, health care providers may recommend subcutaneous immunotherapy, or allergy shots, in which allergens are injected directly into a person’s body. Researchers are no longer pursuing this approach as a treatment for food allergy because initial attempts too frequently caused severe allergic reactions.
Consumption of food that includes baked milk or egg products is a potential alternative to OIT for treatment of milk and egg allergies. Temperature-associated changes in certain milk and egg proteins may render baked versions of these foods less allergenic. However, the same does not hold true for all allergy-triggering foods. For example, roasting peanuts can make them even more likely to cause allergic reactions.
Studies have suggested that some children who are allergic to uncooked egg and milk can tolerate small amounts of these foods in fully cooked products such as muffins. One NIAID-funded study in 2011 found that more than half of baked-milk-tolerant children were able to tolerate foods containing uncooked milk after caregivers followed specific instructions to include baked milk products into their diets. The results also suggested that children who consumed baked milk outgrew their milk allergies more quickly than children who did not. However, many of the children treated with baked products were never able to eat unheated milk without allergic reactions. Read more about NIAID work with baked milk therapy. Additional studies are needed to determine how beneficial the baked food approach can be for certain people with food allergy.