When I set out to write this article, my intention was to write about the forms of OIT from the perspective of someone who had no experience with it; OIT for Dummies, if you will. It’s only within the last couple years that I have started to learn more about therapies for people with food allergy, growing more curious as my allergist told me he wants me to do an oral challenge for dairy. As an allergy adult I had always thought my options were closed off, and I have gone through great pains to finally make peace with that. As such, I had allotted very little mindspace to considering the potentiality of a cure.
With Sick Kids, E.A.T, and other organizations now diving head-first into diverse areas of cures and cause research, my interest has been renewed.
To kick off my queries I spoke with E.A.T President Elise Bates, to gain insight into the types of “treatments for cures” for which they are funding research. We spoke briefly about OIT, SLIT, the patch, and the LEAP study.
I’m always pleased to hear that another child has successfully passed oral immunotherapy and can now tolerate their allergen in specified amounts, but it has never fully connected the dots for myself personally. As an adult with multiple allergens, the strain may not be manageable. When I say strain I mean several things:
Time: taking daily dosage of allergen and avoiding activity or sleep for several hours
Number of allergens: would I have to do this for dairy, soy, all nuts, all legumes in order to have a meaningful impact on my life?
Mental strain/anxiety/mind space: elevated anxiety or fear of potential reactions and what if they happened when I was home alone (I work from home)
Emotional: overcoming the emotional hurdle of voluntarily ingesting something that I have strictly avoided my whole life
Cost: therapies are costly and often (some are covered at least in part)not covered by insurance
Gut health - not just a buzzword
Then Elise and I shifted to talking about the budding gut health and microbiome research. Not just a social media buzzword, gut health is a growing area of interest for many food allergy researchers as we begin to understand the connection between our gut bacteria, our brain, and our immune system. You may have heard of “fecal transplants”, a procedure whereby the gut bacteria from a healthy donor is transplanted into someone who requires it in order to affect significant change in their body and immune system. Once you get over the initial ick-factor of the name, the research is intensely fascinating.
I can honestly say that in all my years as a person with food allergy, the gut health angle is the only strain of investigation that has appealed to me personally, or seemed potentially applicable to my life. Over the years there has been a lot of talk about how introducing allergens early can prevent development of food allergy, or that it was our parents’ late introduction of allergens that caused my generation to be affected. I receive that information with the attitude that it’s great for other people to know going forward, but is not at all applicable to mine or my family’s situation. My mom and brother both ate nuts before developing an allergy, and I was diagnosed based on reactions to breast milk at just a few months old.
In addition to aging out of some studies and knowing that oral immunotherapies are not the right fit for me, I had felt left out of the cure and cause discussions. I know that as an allergy adult with multiple allergens, I’m not alone. That’s why these new strains of research fill me with optimism.
A few weeks ago I had the privilege of attending a presentation by Sick Kids allergists and immunologists, arranged by a dedicated allergy mom, about their current and forthcoming areas of study. One of the doctors raised the point that perhaps food allergy can be acquired in a medley of ways, and so would require diverse treatment options for each patient, much like how cancer is developed and treated (sorry for the parallel, but as a process it is a good comparison). My eyes immediately sprung open; this felt like the missing connection for which I’ve been pining for an answer, and I can’t wait to learn more as this study develops. The microbiome and moisture barrier studies were also discussed, echoing my earlier conversation with Elise.
I came away from that presentation with very conflicting feelings. On the one hand, I was ecstatic about the new developments and leaps that have been made in food allergy research within the last few years. I could feel the energy and motion just from the doctors’ presentation alone. On the other hand, I felt a bit surly about the fact that no big revelations had been discovered in the first 25+ years of my life, despite my hoping and praying. As one of the presenters mentioned, it has taken a while for food allergy to be taken seriously by the medical community. But we’re here now, and I’m bursting with optimism.
Diagnosis and the quest for transparency
Both E.A.T and Sick Kids, independently, are looking into ways to better diagnose and treat food allergy in order to improve patients’ quality of life. People are often misdiagnosed, and may lead a life of avoidance of certain foods to which they are not actually allergic. For example, new patients are now tested for tree nuts individually instead of assuming that they are allergic to all tree nuts. As a patient, this level of transparency and information can be truly impactful.
Diagnosis is not limited to the allergy itself, but also to detecting the onset of anaphylaxis. Doctors are looking into ways to more clearly determine when a patient is having an allergic reaction so that treatment can be quickly administered. The faster epinephrine is given, the better. But right now it’s often a grey zone. For example, I regularly get hives or an itchy mouth, or itchy red eyes, for no apparent reason. It’s just part of having a very reactive body. So you can imagine how difficult it is to tell if those symptoms are normal, or if they will escalate into a more severe episode. The ability to diagnose anaphylaxis quickly and clearly would alleviate a significant amount of stress and anxiety in patients.
Whether you feel drawn to immunotherapies, are waiting on greater microbiome research (like myself), or are content with your allergies and your avoidance strategy, I hope this article inspired in you a sense of optimism. The future of food allergy research is set to become more diverse, varied, and emboldened. I personally can’t wait to see what’s in store.
As a mission ambassador for E.A.T, I encourage you to support their research by donating here.