Radical New Treatment for FA's?

[GoingNuts]

It looks like this article will be in this week's NYT Magazine section.  I'm dashing off to work and haven't had time to read it, but I glanced at the first few pages and it looks like it's about doing OIT for multiple allergens at once:

http://www.nytimes.com/2013/03/10/magazine/can-a-radical-new-treatment-save-children-with-severe-allergies.html?pagewanted=1&_r=1

[CMdeux]

Thanks for posting this one, GN.

I will have to read it later when I have a little more time to soak it up. 

Okay-- coming back.

VERY good writing overall. Outstanding.  My one major quibble is this one:

An EpiPen will prevent death if it’s used within 20 minutes of exposure,

mechanistically, that is not true. "Will" there is incorrect.  "Can" is appropriate, but I didn't like the implication that there is something magical about 20 minutes.  I can't think of a single instance in which my DD's reactions have taken that long to manifest, and her most severe ones have often been with a speed and vengeance that is difficult to even comprehend, never mind describe to someone who hasn't seen it.

  There are recorded deaths which have ocurred within 5 minutes or so of the exposure, and there are some which have been recorded even WITH timely intervention including epinephrine.  That, in my mind, is one of the things that creates a real barrier to getting accommodations in place re: avoidance.  Most people think "well, you have that pen thing," never understanding that it may simply be too little, too late even if it is administered at the same TIME as the exposure, at least in some cases. 

There is evidence that having a parent or a grandparent who smoked — even if the child was never exposed to smoke — is a risk factor for food allergies, as is living in an urban area with elevated pollution.

That is fascinating to me-- and something that I had not heard.  Hmmm-- provoking food for thought, that. 

Nadeau stresses that oral immunotherapy is still experimental. Her patients are not cured; they are desensitized enough that they can tolerate their former allergens. The reason that she doesn’t call it a cure is that the child must continue to eat a maintenance dose of the food every day to avoid regaining the allergy. She often explains to her patients, “If you get off it for three days, you may become sensitive again.” An egg-allergy trial found that when patients were taken off the maintenance dose for a month, roughly 60 percent regained the allergy (and there was no way to predict who those patients would be).

YES.  THIS.   

[Macabre]

We tweeted this early this morning. It is one amazing article. Truly. It's great not only for addressing multiple FA desentization trial at Stanford but moreso from the perspective of a parent of a child with FAs. It's one of the best descriptions if our experience I've ever seen.  And also a great description of FAs.

Just wow. I was bowled over when I read it. Wow. Wow. Wow.

[Macabre]

@FASupport: Amazing @nytimes article abt #foodallergies. Also multi-FA desensitization at @stanford Every FA mom should read. http://t.co/wLzvqoPLjT

[Jessica]

Interesting article. My dd was never around anyone that smokes and we live about as far from urban as you can get (nearest neighbor 1/4 mile, nearest tiny town 20 miles). Apparently it was some other risk factor for us (dh's eczema, my hay fever, maybe?)

[CMdeux]

Yeah, I find the smoking thing interesting because it is something that has a mechanistic explanation as a possible modulator of genetic expression.  That's what the term "epigenetic" means, and this is where you can find shifts that seem to occur over 1-3 generations.

That is too short a timeline for "genetic drift" in a population to explain the changes, and far too long to be simple "environmental exposure" to affected individuals. 

What may be true, though, is genetic modulation which is heritable.  That is, an environmental exposure that CHANGES the genetic information which is passed to future generations.  In conventional terms, these things might be considered teratogens of a sort-- the kind which impact one's grandchildren.

[twinturbo]

lol@comments. I love the roundup of suspects: GMO foods, pesticides, decline of vaginal birth, decline of beastfeeding. Both of mine are vaginal births (no meds), extended beastfeeding, each anaphylaxed to non-GMO, organic peanut and barley respectively. Neither had oral antibiotics prior to their first bout of anaphylaxis, either. As far as fun gut flora we even brought DS1 to Asia as an infant. Ate grandma's food on the table every day with the family. Probably ate some interesting floor funk in coach during the flights.

[booandbrimom]

Yeah, I find the smoking thing interesting because it is something that has a mechanistic explanation as a possible modulator of genetic expression.  That's what the term "epigenetic" means, and this is where you can find shifts that seem to occur over 1-3 generations.

So this is from SIX YEARS ago:

http://www.peanutallergy.com/boards/did-the-grandparents-of-your-pa-child-smoke

Just saying.

[lakeswimr]

Very interesting.  I had wondered if they would try desensitization to multiple FAs at once because otherwise a child like mine would take a really long time.  The smoking thing I wonder about.  The levels of people who smoke now are going way down compared to the past but it said if your parent or grandparent smoked your chances were higher.  I don't know.  I kind of doubt this one because there are countries that have a much higher % of people who smoke and have smoked for generations and if we are not seeing a difference between countries that smoke more and less than I think that would rule that out.  I don't think we see that difference between countries.

[CMdeux]

Yeah, I find the smoking thing interesting because it is something that has a mechanistic explanation as a possible modulator of genetic expression.  That's what the term "epigenetic" means, and this is where you can find shifts that seem to occur over 1-3 generations.

So this is from SIX YEARS ago:

http://www.peanutallergy.com/boards/did-the-grandparents-of-your-pa-child-smoke

Just saying.

  Middle-aged brain at work.  I must have blotted that out-- because I actually recall writing my post in that thread, even...


I just wasn't aware that there were studies or anything examining a putative link to FOOD ALLERGY in particular, I guess.

I also still say that McCobbre (and I) had the right idea there-- how on earth would you know??  Honestly, DH and I were talking about this this morning.

His parents and all of their friends smoked.  My dad was a two-to-four-pack-a-day smoker, and it really wasn't all that unusual.  I'd think that the real challenge there ought to be finding a sufficient number of people who have atopic genetics that WERE NOT exposed like that during the 50's through the 70's or 80's.

People smoked in freaking grocery stores, teacher's lounges, and IN HOSPITALS.  I remember.