Laird Harrison

February 27, 2017

ATLANTA — Promising results from studies on desensitization to tree nuts and wheat will be among the hot topics at the upcoming American Academy of Allergy, Asthma and Immunology Meeting (AAAAI).

"The studies are small but they are very encouraging," said Mary Beth Fasano, MD, from the University of Iowa in Iowa City, who is chair of the program committee.

Until recently, most oral immunotherapies for food allergies were directed at patients allergic to peanuts, she said. But that approach is now spreading to other food allergies.

Data for tree nuts from the past couple of years are just starting to be published, she pointed out.

In a long-term trial of oral walnut immunotherapy that will be presented, researchers from the University of Arkansas at Little Rock investigated whether the walnut-based therapy could lead to desensitization for other tree nuts.

And attempts to desensitize patients to wheat using high-gluten wheat flour will be presented by researchers from Mount Sinai Health System in New York City.

With patients able to achieve desensitization to peanuts, researchers are now hoping to go one step further and get patients to a state of "sustained unresponsiveness."

Sustained Unresponsiveness

Patients achieve desensitization when they can increase the amount of an allergen they consume without having allergic symptoms while they continue to take the oral immunotherapy.

Patients achieve sustained unresponsiveness when they can consume as much of an allergen as they want without an allergic reaction, long after they have stopped the oral immunotherapy.

It's a key distinction, said Dr Fasano.

Two-year follow-up data from the Viaskin Peanut's Efficacy and Safety (VIPES) study of peanut epicutaneous immunotherapy will be presented by researchers from Harvard Medical School in Cambridge, Massachusetts.

"This should absolutely be on everyone's radar," said Dr Fasano. One-year VIPES data showed that the patch infused with peanut protein, which is slowly absorbed into the body, is effective, as reported by Medscape Medical News.

The use of sublingual immunotherapy to bring about sustained unresponsiveness to peanuts will be described by researchers from the University of North Carolina at Chapel Hill. And a study looking at whether exposure to second-hand smoke triggers allergy to peanuts will be presented by a team of Canadian and Swedish researchers.

Not all the research presented at the meeting will focus on food allergy, though.

Pollen Allergies and Asthma

Attendees will hear findings from a European study of a nasally applied cellulose-derived powder used to treat people with grass pollen allergies.

In addition, "there is going to be a lot of neat stuff at related to asthma pathogenesis," Dr Fasano reported.

For example, a trial of vitamin E plasma isoform concentrations for the prevention of wheezing in children will be described by researchers from Vanderbilt University in Nashville, Tennessee.

"Prevention is more than just getting a flu shot and getting your pneumonia vaccination," said Mark Sands, MD, from the State University of New York in Buffalo, who is chair of the AAAAI asthma diagnosis and treatment section.

Experts at the meeting will present evidence showing that nutritional supplementation can be effective during pregnancy, he said.

And national data on disparities in the treatment of asthma will be presented by a team from Stanford University in California and Brigham and Women's Hospital in Boston. In the United States, death rates are much higher in black children than in Hispanic or white children, Dr Sands explained, and this study might shed light on some of the reasons for this.

In his keynote speech, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, will talk about the emergence and re-emergence of infectious diseases.

Dr Fasano and Dr Sands have disclosed no relevant financial relationships.

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