...And a little bit of rambling

While I'm very excited about the news about the peanut allergy study I mentioned in the previous post, I'm also a little unsettled. This treatment completely goes against the current medical advice for food allergies, which is strict avoidance. It's just such a shift in thinking, and it obviously shows promise, but I can't begin to imagine the fear that must have gone through the heart of each parent of each participant in the study the first time the treatment was administered. Some of the participants did have to drop out of the study because they couldn't tolerate the treatment. It was a small number, but it happened nonetheless. If this does end up being developed into a widely-available treatment, will I be brave enough to enroll Bryan?

And there is also a part of me, a very selfish part of me, that is worried about what to say when I talk with people about the study. I want to share this news with everyone who knows what we have been through with Bryan. But then I think about explaining the details of the peanut treatment, which involved dosages of actual peanut protein. And I begin to worry that certain people will point out to me that it is the opposite of our current strict avoidance, and that maybe we have been doing more harm than good. (I have actually had people mention in the past that I should relax with Bryan's food because a little bit of exposure might help him build up a tolerance.) Or that other people might take the study to mean that we don't need to be as stringent with food preparation, so they don't need to read a label quite as carefully here or there.

I know that I'm being ridiculous, really. I know that I can explain that the peanut dosage was very strict- only 1/1000 of a peanut initially, and very gradually increasing over the course of the study, which has been in progress for several years. I know I can explain that everything was administered under strict medical supervision, just in case an allergic reaction did develop. I know that I can explain that there is no way to determine the exact amount of a "trace" of peanut in any particular box of cookies- one cookie could have the equivalent of 1/100 of a peanut while another has 1/5 of a peanut. I know I can explain that this only applies to peanut allergy, and that milk and egg allergies may work via a different mechanism. And I know I can explain that this study hasn't even been published yet, and that it is going to be very thoroughly reviewed and critiqued once it is. I know logically that anyone who really matters will understand all of this, and continue to support us and not question as I continue to obsessively read labels and wash cutting boards. But I still worry, because that's just the way I am.

Promising developments about peanut allergies...

This past weekend, the American Academy of Allergy, Asthma, and Immunology (AAAAI) held their annual meeting in Washington DC. At this meeting, Dr. Wesley Burks (a huge name in the food allergy field) presented some preliminary findings from an ongoing study he is conducting at Duke University and Arkansas Children's Hospital. In this study, 33 participants with a known peanut allergy received daily treatments of peanut protein, starting with the equivalent of 1/1000 of a peanut, and gradually increasing in dosage to the equivalent of 15 peanuts per day. Today, most of the children are now able to tolerate peanuts (in both the treatments and in everyday life) without developing an allergic reaction! (You can read more about the study in the New York Times or view a report that appeared on Good Morning America.) According to Dr. Burks, they may even be able to develop a treatment for peanut allergy within the next 2-3 years.

This is HUGE news for people with food allergies, but a few words of caution first:

• DO NOT TRY THIS AT HOME! The participants received a very precise dosage in a controlled medical setting, with lots of doctors and medical equipment present in case of a reaction. The dosage was very gradually increased, again by a very precise amount. Four participants actually had to drop out because they weren't able to tolerate the treatment. While it is all very promising, Dr. Burks himself says that more studies need to be completed before the treatment can be used outside of the study setting.
• So far, the treatment only applies to peanut allergy. There is another study that is investigating a similar treatment with egg allergy, but the mechanisms for how each food allergy works may be different. What is effective for peanut allergy may not apply to other food allergies.
• These are all preliminary results. The study has not been published yet, and once it has, it will be subject to a huge amount of peer review and follow-up studies and criticisms.

All of that said, this is definitely exciting news! I am trying to get as much information about the study as I can- I will try to keep you updated with new developments as I hear about them...