Toddlers who have a mild peanut allergy

Results from a late-stage clinical trial conducted by an international team of researchers suggest that a peanut patch may help alleviate allergic reactions in children with nut allergies.

Wearing a peanut patch for 12 months has been shown to desensitize toddlers with mild allergies to peanuts, allowing them to safely consume a small number of peanuts without allergic symptoms.

An international clinical trial led by pediatric allergy specialist Matthew Greenhawt from the Children's Hospital Colorado conducted on toddlers aged 1 to 3 years in eight countries across the US, Australia, Canada, and Europe showed that wearing a peanut patch for 12 months effectively desensitized toddlers with mild allergies to peanuts, allowing them to eat a small number of peanuts without experiencing allergic symptoms.

Alkis Togias, an allergist-immunologist at the US National Institute of Health, who was not involved in the trial, writes that the trial results "are very good news for toddlers and their families as the next step toward a future with more treatments for food allergies.

Toddlers were deemed desensitized if they could tolerate approximately one to four peanuts following treatment, which was sufficient to safeguard them from inadvertent exposure.

The desensitization offered by the peanut patch in the clinical trial could provide significant relief to families of children with peanut allergies, who often experience significant anxiety and stress from the constant vigilance required to avoid exposure to allergens.

The team of researchers note that families have expressed the need for treatments that can safeguard their children from unintentional peanut exposure, as it would enhance the socialization and quality of life of both the children and their families.

The patches are intended to expose children with peanut allergies to controlled, small doses of peanut protein through the skin, in order to desensitize them. While it may seem risky, emerging evidence suggests that this approach could be effective in treating food allergies.

Research on children's food allergies is rapidly advancing, particularly in Australia, where studies have revealed that one in ten infants suffer from a food allergy, making it the food allergy capital of the world.

Food allergy rates are increasing in countries like Australia, with one in ten infants affected, and while the reason is not yet known, theories include environmental factors such as low vitamin D levels, and changes in the gut microbiome due to fewer childhood infections, according to researchers.

Children with eczema have a higher likelihood of developing food allergies, as studies suggest they may have been exposed to allergens through their skin before ingesting them, which can trigger the immune system to react negatively to food.

Allergy specialists have recognized the importance of early intervention to prevent food allergies, and parents in Australia and the US are now advised to introduce known allergens into their infants' diets instead of avoiding them to prevent allergies from developing.

There is currently no cure or approved therapies for kids under four years old with food allergies, and research shows that about two-thirds of young children don't outgrow their peanut allergy by age six, highlighting the need for developing a therapy.

"The lovely thing about [a skin patch] is it is much, much, much safer than taking something orally," Murdoch Children's Institute pediatric allergist and co-author Kirsten Perrett said when speaking at a conference last year about new therapies in the works for food allergies.

The doses of allergens applied in a skin patch are far lower than doses used for oral immunotherapies (essentially crushed-up peanuts taken in a tablet form). And although children may still develop some skin irritation or adverse reactions, patches are a much simpler – and potentially safer – alternative to oral immunotherapy, which involves arduous treatment schedules.

Results from trials testing oral immunotherapies have been mighty encouraging. One kind of oral immunotherapy for peanut allergy has been approved in the US, but it's only for kids older than four, and oral immunotherapy remains controversial because it carries a high risk of serious allergic reactions.

The safety of peanut patches is also under close watch. Four toddlers in the patch trial experienced an anaphylactic reaction related to the patch; one child pulled out of the trial while the other three resumed treatment without reacting again.

How long a child would have to wear a patch to ensure lasting benefit is also a big unknown that other trials are exploring.

If future trials can replicate the study findings, and show that peanut patches are a safe option that fairly balances the risks of a reaction in a few children with the benefits of many more kids being able to tolerate peanuts in small doses, then we might be onto a good thing.