Beating peanut allergies

Boiling peanuts for up to 12 hours could help overcome children’s allergic reactions according to the results of a clinical trial at Flinders University and SAHMRI which found up to 80% of children with peanut allergy became desensitised to eating peanuts.

The clinical trial, which was funded by the Channel 7 Children’s Research Foundation and published in the journal Clinical & Experimental Allergy, tested whether a therapy delivering sequential doses of boiled peanuts, followed by roasted peanuts, may help children overcome their peanut allergies.

The trial built on previous research conducted by senior author and Flinders University’s College of Medicine and Public Health Associate Professor Tim Chataway showing that heat affects the protein structure and allergic properties of peanuts, meaning they were less likely to cause a severe allergic reaction.

“Small and increasing doses of boiled nuts were first given to children to partially desensitise them, and when they showed no signs of an allergic reaction, increasing doses of roasted peanuts were then provided to increase their tolerance in the next stage of treatment.”

To achieve this multi-step process known as oral immunotherapy, the researchers asked 70 peanut-allergic children (6-18 years) to consume peanuts boiled for 12 hours for 12 weeks, 2 hour boiled peanuts for 20 weeks, and roasted peanuts for 20 weeks.

This novel two-step therapy was tested in anticipation of achieving daily targets of participants consuming 12 roasted peanuts without allergic reactions.

The results show 56 of the 70 (80%) participants became desensitized to the target dose of peanuts. Treatment-related adverse events were reported in 43 (61%) of participants, however only 3 withdrew from the trial as a result, demonstrating a favourable safety profile.

Flinders University’ College of Medicine and Public Health and South Australian Health and Medical Research Institute Associate Professor Luke Grzeskowiak, the lead author of the study, says with up to 3% percent of children in Western countries grappling with peanut allergies, this clinical trial could help develop a novel treatment pathway to reduce the risk of accidental peanut exposure and significantly improve quality of life for peanut allergic children and their carers.

“Our clinical trial shows promising early signs in demonstrating that boiling peanuts may provide a safe and effective method for treating peanut allergic children with sequential doses of boiled and roasted peanuts over an extended period of time,” says Associate Professor Grzeskowiak, Channel 7 Children’s Research Foundation Fellow in Medicines Use and Safety.

“With no currently approved treatment for peanut allergy in Australia there is a lot more research to be done. Unfortunately, oral immunotherapy doesn’t work for everyone and we are in the process of improving our understanding of how these treatments work and what factors can influence how people respond to treatment. This will be really important for assessing individual suitability for treatment and improve treatment decisions in the future.”

The study was undertaken in collaboration with Paediatric Allergist Dr Billy Tao, who has been developing the novel desensitisation process to treat peanut allergies for the past decade after being inspired by similar research in the 1990’s.

The study authors conclude that while these findings hold great promise that current approaches to oral immunotherapy could be made safer and more effective, but this requires confirmation in a larger definitive clinical trial.