Combination Therapies for Food Allergies in Children

Increasing Need for Effective Treatments

With a rise in food allergies among children, researchers are exploring combination therapies aimed at reducing the severity of allergic reactions. A recent study assessed the effectiveness of the antibody drug omalizumab alongside oral immunotherapy in children suffering from multiple food allergies.

Understanding Allergic Reactions

Allergic reactions occur due to the overproduction of Immunoglobulin E (IgE) antibodies. Typically, IgE is released in response to real threats to the immune system. However, in allergic individuals, IgE responds to harmless substances, termed allergens, leading to potentially life-threatening inflammatory responses.

Role of Oral Immunotherapy

Research indicates that small amounts of an allergen can lessen the severity of future allergic reactions. Oral immunotherapy, which involves the consumption of the allergen, has proven effective for individuals with single-food allergies. However, there is a lack of studies focusing on oral immunotherapy’s impact on multi-food allergies, which account for about 30% of all food allergy cases. A recent article published in the British Medical Journal highlights a pioneering study in this area.

Study Overview

Research Publication

The study, published in the Lancet Gastroenterology and Hepatology, examined the effects of omalizumab on oral immunotherapy in children with multiple food allergies. Omalizumab is an anti-IgE antibody previously known to reduce the severity of single-food allergic reactions.

Study Details

The trial involved 48 children aged 4 to 15 years with multiple food allergies. Participants underwent treatment for 16 weeks, receiving either omalizumab with oral immunotherapy or a placebo with oral immunotherapy. Researchers measured desensitization at 36 weeks, defined as the ability to consume at least 2g of allergen foods without triggering a reaction.

Results and Implications

Increased Rates of Desensitization

Results revealed that 83% of children in the omalizumab group achieved desensitization to at least two allergens, compared to just 33% in the placebo group. Notably, no serious adverse events occurred during the study, with only gastrointestinal side effects reported in both groups. These findings suggest that omalizumab may significantly enhance the desensitization process for children with food allergies.

Considerations for Future Research

Despite the promising results, researchers caution that the long-term persistence of desensitization remains unknown. Additionally, the effectiveness of omalizumab may be limited for children with very high IgE levels, such as those with atopic dermatitis. Further studies are necessary to explore the underlying mechanisms and potential therapeutic applications.

References

(1) Mayor S. Antibody drug improves desensitisation with oral immunotherapy in children with multifood allergy, study finds. BMJ. December 2017. doi:10.1136/bmj.j5736.
(2) Allergy Treatment Spotlight: Oral Immunotherapy (OIT). Food Allergy Canada. http://foodallergycanada.ca/2017/06/allergy-treatment-spotlight-oral-immunotherapy-oit/. Published June 2, 2017.
(3) Facts and Statistics. Food Allergy Research and Education. https://www.foodallergy.org/life-food-allergies/food-allergy-101/facts-and-statistics