The Cat is out of the Bag

The cat is out of the bag: no pun intended. Allergies happen and if they have happened to you, you number in the ranks of 20% of the US population. Allergies come in all shapes and sizes, many people have a few annoying weeks of hay fever during the spring that is readily treated with an over the counter antihistamine. On the other end of the spectrum is the individual with months of sinus symptoms, asthma, eczema, and life threatening food allergies. Allergies are a lifestyle issue and those with more severe disease or life threatening food allergies are impacted on a daily basis. The fear of accidental food exposure increases anxiety among patients and families, especially if there are multiple food allergies. One survey even found that one in four children had been taunted, bullied or harassed because of their food allergy.  Education and preparedness are the best tools to combat these fears and fortunately there are a number of resources to help you. The first resource I wanted to point out is the Food Allergy and Anaphylaxis Network or FAAN (www.foodallergy.org). This nonprofit organization provides education on food avoidance, and offers programs to assist patients and families in matters of food shopping, food avoidance in the school and camp environment, vacation planning, dining out strategies, and emergency management plans for accidental food exposure. This organization has cookbooks, online recipes, and food substitution suggestions for the major food allergens.  FAAN also has  a number of instructional programs available on the website including The School Food Allergy Program and The Child Care and Preschool Guide to Managing Food Allergies. There are also food allergy apps for smart phones that help with food shopping and menu planning. The FAAN website reviews some of these apps. Other helpful resources (and this is by no means an exhaustive list)include The American Academy of Allergy, Asthma, and Immunology (www.aaaai.org), The American College of Allergy, Asthma, and Immunology (www.acaai.org), Asthma and Allergy Foundation of America (www.aafa.org), Mothers of Asthmatics (www.aanma.org), The American Lung Association (www.lung.org), the website UpToDate(R) (www.uptodate.com, click patient and search for food allergy, allergic rhinitis, and asthma), the National Eczema Association (www.nationalezcema.org), and the American Partnership for Eosinophilic Disorders (www.aphed.org).

Over the past several years the treatment for allergic disease has vastly improved. There are a number of safe and effective medications for allergic rhinitis, asthma, and atopic dermatitis.  Allergy shots also remain a tried and true therapy for allergic rhinitis and asthma. Furthermore, the National Institute of Health created 2 nationwide programs to further study and improve asthma treatment. The Asthma Clinical Research Network (www.acrn.org) studies asthma treatment strategies for adults while the Childhood Asthma Research and Education or CARE network (www.asthma-carenet.org) focuses on asthma diagnosis and treatment in the pediatric population.

I would like to end the blog with some comments on the future direction of food allergy. At this time food allergen avoidance is the only means to prevent life threatening food reactions. A number of future studies are underway to see if there may be an alternative treatment strategy. Studies are currently being performed looking at oral immunotherapy for peanut, egg, and milk. Some of the results hold promise and as more studies are done this may be a potential future option for certain food allergic patients. Human studies are planned for engineered recombinant protein immunotherapy. This form of therapy looks at taking the allergic part of the peanut molecule and changing it so it does not cause an allergic reaction but instead causes a protective antibody to be formed.  Finally there is a proprietary herbal formulation developed at the Jaffe Food Institute in New York that in mouse models has blocked food induced anaphylaxis. Human studies with the agent are underway.  As the mystery of the human immune system is unraveled, more life changing therapies will be available for us and our children.

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