A small study involving 48 participants suggests peanut allergy can be cured or at least ‘suspended’ following a treatment consisting of probiotics and peanuts.

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Nut your average therapy

Peanut allergy is one of the most common food allergies and can result in a severe and potentially fatal immune response. It’s not just peanuts — nuts or certain legumes can cause it too. You likely have friends or know someone who had to be rushed to the energy room after accidentally ingesting allergenic food. Suffice to say, all of this can be incredibly annoying, not to mention dangerous. One study estimates the quality of life of children with food allergies is worse than that of children with diabetes. You can stay away from peanuts and derivatives but there’s always the risk of coming in contact with the allergenic by accident.

Our immune system is great at warding off infections, but when a person is allergic to nuts, the immune system overreacts to the proteins in these foods and treats them as “invaders”. This causes a severe allergic reaction called anaphylaxis in which chemicals called histamine are released in the body. Anaphylaxis may begin with some of the same symptoms as a less severe reaction, but then quickly worsen, leading someone to have trouble breathing, feel lightheaded, or to pass out. If it is not treated quickly, anaphylaxis can be life threatening. It’s also an allergy that haunts those afflicted all their lives, but a new groundbreaking research might prove to be a life raft.

This is why the latest study performed by scientists at the University of Melbourne has gotten a lot of people hyped about the prospect of saying farewell once and for all to peanut allergy.

The trial involved 24 participants which were given a mix of the probiotic Lactobacillus rhamnosus with peanut oral immunotherapy (PPOIT). L. rhamnosus was previously shown to “induce regulatory T cells, antigen-specific IgA, and regulatory and T helper 1 cytokine responses.” In other words, it heightens the immune system response. Previously, clinical trials established PPOIT can prevent the food allergy by eating small, gradually increasing amounts of the peanuts under very strict and careful supervision of a trained allergy specialist.

When compared to an equally-sized placebo group, the team found their trial to be very successful. Four years after the treatment was administered, 20 out of 24 said they had no allergic reaction. What’s more 16 ate peanuts freely and regularly and 11 said they had them once a week, as reported in The Lancet Child & Adolescent Health 

The researchers used questionnaires to record participants’ peanut intake history, including the average amount ingested, ingestion frequency, and adverse reactions to peanuts after accidental or intentional ingestion since stopping study treatment. Participants and their nurses also completed a quality of life survey while skin prick tests — standard tests that measure allergy biomarkers — where used to measure allergen reaction.

“To conclude, our results suggest that PPOIT is effective at inducing long-term sustained unresponsiveness that persists for up to 4 years after completing treatment and is safe. Furthermore, the finding that sustained
unresponsiveness was maintained without the need to follow a regular prespecified ingestion schedule provides a compelling argument that PPOIT-induced immune tolerance,” the authors concluded.

Now, the big caveat is that this was a small study which included just two dozen participants who received the treatment. It’s not clear that anyone is really cured, rather it might just be that the allergy is kept under control temporarily and the treatment might have to be restarted.

Nevertheless, this is a compelling proof of concept which will soon feature more trials which include more people. Previously results also seem to lend confidence that there is promise in this therapeutic direction. In 2015, the same Australian researchers gave 30 allergic children a daily dose of peanut protein together with the L. rhamnosus probiotic. At the end of the trial, 80% of the children could eat nuts.

In any event, even if a clinical trial proves safe tomorrow, the regulatory hurdles means an FDA-approved peanut immunotherapy might take years before it reaches those in need.