'I like to taste the peanuts now': Immunotherapy study shows promise for preschoolers with allergies

Eating gradually increasing amounts of peanuts appears to be a safe and effective therapy for preschoolers with nut allergies, according to a new study from B.C. researchers.

The process, known as oral immunotherapy, allows children to build up tolerance by eating peanuts every day.

Researchers from the University of British Columbia and B.C. Children's Hospital followed 270 Canadian children who received the therapy for 19 months, and their data was published this week in the Journal of Allergy and Clinical Immunology: In Practice.

"We found that it was very safe. Only 0.4 per cent of the preschoolers … experienced a severe reaction, and out of 40,000 or so doses of peanuts that were administered, only 12 required epinephrine," senior researcher Dr. Edmond Chan said.

The children, all between the ages of nine months and five years when the study was launched, began by eating small amounts of peanuts under the supervision of a pediatric allergist, and then received daily doses at home.

Every two weeks, they returned to the doctor and the dose increased, until they were able to handle 300 milligrams of peanut protein a day — about the equivalent of one peanut.

Twenty-seven kids dropped out of the study before it was over because of repeated allergic reactions, refusal to eat peanuts or parental anxiety.

'Her allergies kind of absorbed our family'

Immunotherapy, which is used to treat many other allergies, works by gradually desensitizing a patient's immune system so that it stops reacting to substances.

Ravinder Dhaliwal described the therapy as a life-changer for her family, and especially for her five-year-old daughter Saiya, who was diagnosed with a peanut allergy at 10 months old.

"Her allergies kind of absorbed our family… We couldn't have nuts in the house," Dhaliwal said.

"My other child is a picky eater and the only thing he seemed to want to eat was a peanut butter sandwich. We could not give him that."

Now, Saiya can sit right beside her brother while he eats a peanut butter sandwich.

Saiya enjoyed the process, too.

"I like to taste the peanuts now and I like the way the colour is," she said.

'Protection from accidental exposures'

Chan said the therapy may help protect children from the anxiety, social isolation and even bullying that sometimes accompany serious nut allergies.

"At present, this is felt to largely be protection from accidental exposures, but even then, parents seem to be very happy if they can at least offer them that," he said.

The new research builds on a 2017 study that followed a small sample of 37 preschoolers. Previous studies have shown that immunotherapy can be effective in older children.