Reply to Is there anything new in the nut allergy treatment world?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]Hi OP, I work in food allergy. I can tell you we are all eager for the announcement of Xolair, which could before the end of the year, with a Q1/Q2 FDA approval.

It's important to differentiate Xolair is not being considered a cure for food allergy, but a medicine that takes away the risk of anaphylaxis on accidental exposure. Still lots of questions to be answered- monotherapy vs with OIT, can it help get to sustained unresponsiveness with the right pt (either bite proof or "free eating"), will it be needed for life or a period of time? Lots to consider, and pt age and acuity will factor in, but a potent new tool.

Dupixent trials have been less promising for food allergy, though a wonderful biologic for eczema, asthma and may still have use. I share the reservations about OIT. In application, there are many hurdles of which families often aren't aware. A pt and family will want to be fully informed and make a shared decision with an allergist.

[b]And since I'm here, please help get this message out, EARLY INTRODUCTION IS ESSENTIAL[/b]. All the top allergens into the diet in age-appropriate forms when your child is ready for solids at 4-6 MONTHS OF AGE. Yes, that early. If there is any hesitation (bc of eczema, sibling/family history, etc), get to an allergist for support, but don't unilaterally take it out of your child's diet. We now know this has the possibility to potentiate an allergy and there is for many a window on immune plasticity.

Thanks for indulging the PSA, best of luck OP.[/quote]

I'm so curious if you have input/theories on causes of food allergies and the rise of food allergies in children. Our first is allergic to tree nuts, initially also dairy and egg, but passed oral challenges to both of those by age 2. With his sister, we followed ALL of the guidelines for early introduction with a mix-in formula starting at 4 months and continued to offer bamba, lara bars, dairy, egg, everything. She never liked straight peanut products so we didn't force it, but we didn't remove them or restrict her from eating peanut-containing cookies, candy or anything. So it was pretty shocking when at age 7 she had an anaphylactic reaction to ice cream and was formally diagnosed with a peanut allergy. I know this is atypical and we feel like we did everything "right" to avoid. No history of allergies in the family other than her brother, but they both had eczema as infants and toddlers.[/quote]

I've read about the theory that specific gut bacteria may be responsible for allergies.    Hopefully this line of research will be pursued.
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