My daughter has Celiac disease. It was diagnosed at age 4 when her growth chart showed she did not gain a single pound and grew ¼" from age 3-4. We did a biopsy of her small intestine and it was completely smooth. (Should be almost like velvet) Herblood levels also showed high sensitivity to gluten. We have her on a strict gluten free diet and she has since followed the growth chart perfectly. However she is sensitive enough that she can not eat gluten free food that has been prepared on the same grill/pan/cook or prep surface as food containing gluten. She suffers from nausea and diarrhea when cross contamination occurs. What this means is that I have to cook every meal she eats and bring it with us if we go to restaurants. We live in probably the best time ever for gluten free foods, but this is still a significant hardship for her. She is 7 now and I worry about as she gets older and wants to hang with friends/date/college. Unless things change she cannot just go grab food at a restaurant. Some restaurants have a gluten free protocol (PF changs comes to mind) but this is not common. From what I've read gut bacteria could be a contributor to gluten intolerance. I really hope studies like the peanut allergy encourage other dietary studies and immunotherapy becomes more common. Her having celiac disease is not the end of the world but her quality of life would change drastically if she didn't have to worry about that.
The AAP also recently changed its guidelines for introducing peanuts to babies based on a study [1] showing a pretty dramatic decline in the development of the allergy with early exposure vs total avoidance.
[1]http://www.nejm.org/doi/full/10.1056/NEJMoa1414850#abstract
Does anyone know the history of why allergists assumed this just wouldn't work for decades? I'm assuming they initially tried this at the dawn of the allergist specialization but gave up due to bad practices / deaths?
I only ask because it seemed to have been general knowledge that this was impossible / couldn't be done up until recently. As a outsider looking it, it seems quite obvious, but that's just due to naivete.
I'm a parent of a 4-year old with a peanut allergy. We've been told that anywhere from 18-25% of kids with it "outgrow" the allergy by age 5. I've been looking into private practice oral immunotherapy (OIT) recently, which this protocol seems to be a variant of (adding the bacteria). My understanding is that you start with a low dose and then gradually increase over months until you're eating whole peanuts (4-12 of them) in the morning and evening as a maintenance dose. From what I've found, this can work for many types of food allergies and for all ages and all sensitivities.
Very severe peanut allergy here - honestly go away with this crap of comparing your gluten allergy. I have to carry an epipen and worry about risking my life when I so much as eat food that was on the same table as baked goods that MIGHT have traces of peanut butter.
When in her teens, my daughter developed a peanut allergy during her time in drum corps such that it was confirmed with skin patch tests and she had to carry an epi-pen. After about a year it just went away and she's back to "normal".
True story: in Russia (and I can only assume other Eastern European countries) peanut allergy is so rare that I've never even heard of it until I emigrated. Pollen allergy is about the same, ragweed pollen allergy can be really bad too. But not peanut allergy.
I wonder if they had a control group taking only the bacteria, and another one taking only peanut proteins. If not, why did they decide on this combination?
What's amazing to me is that they used to recommend you don't give children any peanuts until a specific age, but then they learned that easily exposure actually dramatically decreases the chance of developing an allergy.
I feel like I have to throw away almost all advice they give us about kids these days. These types of things do a lot to undermine the advice of doctors.
This seems so obvious, and I've been hearing about this approach for years and years. Yet it still feels like 20 years from now, this will still not be a treatment, and kids classrooms will still be "nut free", and more and more kids will be carrying around epi-pens which will still cost a fortune.
Journal article is here: http://thelancet.com/journals/lanchi/article/PIIS2352-4642(1...
Can we derive that Lactobacillus rhamnosus could reduce all kinds of allergies when taken, even without adding proteins that you are allergic to?
Yumm... I can't wait for the shellfish version! I would love to try shrimp again and find out what all the fuss is about with lobster.
My daughter is allergic to eggs, salmon, and fish in that similar family. Having vegan options in this modern day has been a real help.
I started my food side project https://bestfoodnearme.com with the idea in mind that I can catalog dishes at restaurants based on allergies, gluten free etc. Allergic reactions are a very scary thing especially with small children.
Could this be made to work on allergies in general? The article suggests it could at least be used for food allergies in general.
A previous article (2015) talked about the same study http://www.abc.net.au/news/2015-01-28/probiotics-offer-hope-...
48 children were enrolled in the trial. Half of them were given the treatment and half the placebo, leaving 24 children in each group. Statistical significance testing is reported in the article and seems fairly robust, but this is too small a sample size to be fully confident in the results.
Will this work in adults too?
If you're in the bay area and considering OIT, a friend of mine is opening a private practice offering only OIT [0], starting next Wednesday in Redwood City. She is currently a full-time clinician at the Sean N. Parker Center for Allergy and Asthma Research at Stanford University.
Her clinic is relatively unique, in that it will be offering multi-allergen rapid desensitization. Using this procedure, a person can be desensitized to multiple allergens simultaneously, in as little as three months. She can treat milk, egg, wheat, soy, peanut, tree nut, fish, and shellfish allergies.
[0]: http://wmboit.com
I have a young cousin who had a pretty severe nut allergy. After receiving chemo for cancer treatment, she was cured of both the cancer and the nut allergy.
Someone watched the Princess Bride - I spent the last few years building up an immunity to peanut powder.
Link to the original 2013 study http://www.jacionline.org/article/S0091-6749(14)01737-0/pdf
Interesting how this bacteria is a common ingredient in yogurt.
Is nut allergy a rising issue for other parts of the world?
When I was a kid I never heard of peanut allergies. What happened? Did children's guts change? Did peanuts?
Physician-scientist here. My graduate work was in an immunology lab. Just wanted to clear up some confusion I've seen in multiple posts.
While both peanut allergy and celiac disease involve pathogenic immune responses, they represent very different types of problems and this study's results do not suggest any relevance to celiac.
The peanut allergies that they are referring to in this study are one of the most striking examples of what's known as a Type I hypersensitivity (IgE-mediated/anaphylaxis). In this type of reaction, high levels of IgE, a class of antibody, generated toward a specific antigen become loaded onto mast cells and on re-exposure, cause mast cell degranulation and subsequent smooth muscle contraction. For this reason, anaphylactic responses frequently involve closing of the airway, nausea/vomiting, and other dysregulations of smooth muscle activation and require a strong adrenurgic agonist like epinephrine to counteract this activation.
Celiac pathogenesis is not a Type I hypersensitivity. To my knowledge, the exact mechanism of pathogenesis is not known, but it is likely a combination of Type III (antibody-mediated) and Type IV (T-cell mediated) hypersenitivities.
Anyway, I'm not trying to ruin anyone's hope here, but this study has no relevance for celiac. What this has shown is that there is the potential for food allergies to be systematically eliminated with long-term increasing exposure to the problematic antigen, in this case, peanut antigen. This has been done for some time with other, less aggressive types of IgE-mediated conditions like dog and cat dander allergies. So in that way, it's not all that surprising of a result, but I'm certainly glad to see that this was able to be done safely. This is really great news for the millions of people out there with anaphylactic food allergies.
All that being said, I do hope that celiac can be managed more effectively with immune-modulatory (or other) treatments in the future and my sympathies go out to those who have been affected by this horrible disease.