Peanut allergy: a cure in prospect

Larissa Melville completed her traineeship in the editorial team of . After studying biology at Ludwig Maximilians University and the Technical University of Munich, she first got to know digital media online at Focus and then decided to learn medical journalism from scratch.

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Traces of peanuts can be found in many foods. For peanut allergy sufferers, this is life-threatening. Oral immunotherapy in combination with probiotics now gives hope.

Desensitization, also known as specific immunotherapy, is already a common method for treating allergies, especially hay fever. The doctor regularly administers a small but increasing dose of the allergen to the patient over a longer period of time. In this way, the body should gradually get used to the allergen and downregulate the excessive reaction when there is renewed contact.

A pinch of peanut flour daily

Professor Mimi Tang and her colleagues at the Australian Royal Children's Hospital in Parkville have also succeeded in achieving this effect on children with a peanut allergy - and this is apparently permanent.

Several years ago, the research team administered up to two grams of peanut flour per day to 56 peanut allergy sufferers between the ages of one and ten years for a period of 18 months. The special thing about it: In addition, the children received a high dose of probiotic lactic acid bacteria (Lactobacillus rhamnosus). These promote a healthy intestinal flora and are said to have a positive effect on the immune system. "The daily amount of bacteria corresponded to about 20 small yoghurt cups," Tang reports in an interview with A placebo group was used for comparison. Instead of the peanut-probiotic mixture, they got pure corn starch every day.

Two to five weeks after stopping the daily peanut dose, over 80 percent of the children treated showed a potentially permanent tolerance. "These children were able to eat peanuts immediately after the study without having an allergic reaction," says Tang. In contrast, it was less than four percent in the placebo group. The treated group also showed a lower reaction to the skin prick test, in which the allergen enters the skin through a small incision.

Lasting effect?

However, it was unclear whether the success was permanent. To check this, the parents of 48 children, half of whom came from the treated group and half from the placebo group, noted for four years whether their children ate peanuts and whether they had allergic reactions as a result. The researchers are now evaluating this data. In addition, they did another skin prick test.

The result: 67 percent of the 24 children in the treated group continued to eat peanuts. There was only one child in the placebo group. Four of the treated children and six from the placebo group had allergic reactions during the four years when they consciously ate peanuts or accidentally ate them. None of the children had an allergic shock. After four years, the prick test also only caused significantly smaller wheals in the treated children than in the placebo group.

“Our study shows that the effects of our probiotic peanut immunotherapy have long-term success in the majority of children. About two thirds of the treated children were able to eat peanuts four years after the treatment, mostly without an allergic reaction, ”Tang summarizes the results. This suggests that probiotic peanut immunotherapy is effective and could enable all sufferers to eat peanuts and provide long-term protection against allergic reactions.

Lactic acid bacteria - the key to success?

Since Tang and her colleagues' study at the time did not include a control group with children who were only given peanut flour without the administration of lactic acid bacteria, it remains unclear what role the bacteria play in desensitization. "I don't think oral immunotherapy would have been that successful on its own," says Tang. Other studies that tested oral immunotherapy had significantly worse results. "To be on the safe side, we are currently investigating the effect of oral peanut immunotherapy with and without probiotics in another study," says the researcher.

Life-like chocolate enjoyment

It is difficult for those who are allergic to peanuts. Traces of peanuts can be found in many processed foods, including chocolate, but also cakes and spreads. In addition, the allergy is often difficult. Even small amounts are enough to cause allergic symptoms such as itching or wheals. Allergic shock, which can be fatal, is also a constant danger for peanut allergy sufferers. Those affected must therefore check every food before consumption - they are permanently in danger when shopping or eating.

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