UNC part of a groundbreaking food allergy study that shows a treatment that has helped asthma patients for more than two decades could lessen — or even prevent — acute allergic reactions to foods.
Kristen Bush remembers the first time her firstborn suffered a severe allergic reaction.
Braylon was 7 months old, and he had just started eating solid foods. That night, it was a few pieces of one of those little puff cereals. About an hour later, Bush was nursing her son before bed.
“He just kept, like, choking and coughing and choking. And we were like, ‘What is going on?’” she recalled.
When she unzipped his onesie, Bush saw Braylon’s body was covered in hives. They used an Epipen that their pediatric allergist had given them as a precaution, then took him to the hospital where their baby boy was monitored for a few hours before going home.
Neither she nor her husband, Josh, has allergies. There’s no history of allergies in either of their families.
“In the beginning, it was a little bit hectic, I would say, and stressful,” Bush said about learning how to deal with her son’s food allergies.
She signed up Braylon, who’s now 5, for a study at UNC Chapel Hill that is aimed at helping kids and adults who are allergic to multiple foods. Braylon tested as allergic to peanuts, milk, wheat, eggs, tree nuts, sunflower and sesame.
Last year, the Food and Drug Administration approved the medicine used to treat Braylon during the study — co-authored by three UNC Chapel Hill researchers — to treat food allergies based on the study’s early-phase results. Their work showed that a treatment called omalizumab, which has helped asthma patients for more than two decades, could lessen — or even prevent — acute reactions to food allergies.
“As a parent of a kid who has allergies, it gives me peace of mind,” Bush said. “[It] also gives him a lot more food freedom.”
‘A real game changer’
“Omalizumab is going to be a real game changer when it comes to food allergy,” said Edwin Kim, chief of the Division of Pediatric Allergy and Immunology and director of the UNC Food Allergy Initiative at the UNC School of Medicine.
Kim worked on the study with colleagues Corinne Keet, professor of pediatrics and associate director of UNC Children’s Research Institute, and Mike Kulis, a pediatric allergy and immunology associate professor and member of UNC Children’s Research Institute. Researchers at Johns Hopkins and Stanford universities led the project.
“This gives us something that we can offer in the clinic now that will provide a level of protection,” said Kim, who sees patients with allergies in his practice.
The patient must stay on the medication to benefit from the effects. And it’s an injection, which some people won’t like.
“It will help a lot of people out there, but it won’t be for everybody,” Kim said.
Some patients may decide to stay on the medication long term. For others, it might be for specific time periods. He’s seeing those decisions in his clinical practice.
“The people that have expressed probably the most interest are people that are experiencing transitions in their lives,” he said.
He gave the example of a college student leaving home and learning to cook for themselves for the first time after having a parent supervise their food intake. Another example, he said, is when young children first attend school.
Allergies increasing in children
More than 33 million people in the U.S. have a serious and potentially life-threatening food allergy, according to Food Allergy Research & Education, a Virginia-based nonprofit. The group says that food allergy sends a patient to the emergency room every 10 seconds.
The number of children with at least one food allergy has been steadily growing, with 5.6 million children — nearly 8 percent — allergic to some type of food. That’s equal to one in 13 children, or about two per classroom.
So what causes an allergic reaction? When our bodies encounter a foreign substance, whether it’s a virus or a bacteria or a food molecule, pet dander or certain foods, specialized immune system cells known as B cells kick into action. The B cells produce proteins known as antibodies that target those foreign substances, surround it and help our bodies process it for removal. With an allergen, the body perceives it as a threat, flooding the system with antibodies and other chemicals, going into overdrive to attack the usually harmless substance.
This overreaction by the immune system leads to symptoms ranging from watery eyes and hives to breathing problems and even death when severe cases aren’t treated quickly.
There’s no cure for allergies, although children often outgrow allergies to such protein-rich foods as milk, egg, wheat and soy. Children with allergies to peanuts, tree nuts and shellfish generally remain allergic into adulthood, research shows.
Medication can help manage symptoms. Now omalizumab, which is sold under the brand name Xolair, can be used to lessen or avoid severe food allergies.
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