Food Allergy Education Advisory Council
The National Peanut Board’s (NPB) Food Allergy Education Advisory Council met in advance of the annual American Academy of Allergy, Asthma and Immunology (AAAAI) in San Francisco at the end of February. The group is chaired by pediatrician JJ Levenstein and includes representatives from food allergy research, advocacy, school health, and foodservice. Members of the group provide valuable feedback on food allergy related issues, assisting NPB in understanding how to best interact, support, and participate in issues related to peanut allergies. Of note, Jessica Gerdes, who has served on the Council representing the National Association of School Nurse Consultants, has retired and rotated off the board and we welcomed her replacement Victoria Ladd of South Carolina. School nurses play a pivotal role in the school health environment and Jessica’s perspective has been of incredible value to the Council over the past several years. In addition, Mary Jane Marchisotto, CEO of Food Allergy Research and Education (FARE), is a new member of the Council, joining Eleanor Garrow-Holding, president and CEO of Food Allergy and Anaphylaxis Connection Team (FAACT) in the area of advocacy. Special guests at this year’s meeting included Jennifer Gerdts and Ranjit Dhanjal of Food Allergy Canada.
Joining by Skype, Gideon Lack, pediatric allergist and researcher from Kings College, London and author of the LEAP Study presented his thoughts on peanut allergy prevention from a public health perspective. This was a perfect segway into an introduction of the National Peanut Board’s consumer campaign to increase awareness of the latest guidelines to introduce peanut foods early as a way to help prevent peanut allergies.
Soheila Maleki, research chemist for USDA, also presented her research in the area of diagnostics, which is being partially funded by the National Peanut Board. The group engaged in valuable conversation in all areas of food allergy management, diagnosis, and communications.
American Academy of Allergy, Asthma and Immunology (AAAAI) Annual Meeting
This year’s AAAAI meeting was packed with sessions and the release of exciting research about peanut allergies. In fact, there were presentations on preventing peanut allergies, management of food allergies in community and school settings, and lots of buzz about current and future treatments. Here’s a quick overview of top trending peanut-related topics from the conference.
The news about peanut allergy prevention continues to be good, yet the implementation of current guidelines comes with challenges. Sessions at the conference included conversations around testing infants for peanut allergy before introducing peanut foods; how to treat specific patients like those with eczema; and how to perform an oral food challenge in office. The good news is that the audience overwhelmingly knew about early introduction. However, managing introduction to the high-risk infant quickly and safely is still a challenge.
Several sessions at this year’s conference focused on managing food allergies. From the clinical management of oral food challenges (OFC) and treating anaphylaxis to navigating patient-centered care and reducing risk in schools, the sessions were robust in their presentation of the evidence. Treating anaphylaxis was also an important topic with some conversation about the benefits vs. risk, along with the need for a visit to the emergency department following use of epinephrine. Another hot topic within management was the need to provide patient-centered care and recognizing that even though treatments may soon be available for those with food allergies, some patients will choose continued avoidance instead. Finally, sessions on management generally focused on increasing self-efficacy and quality of life. Sessions were held on management in schools and community settings, and also highlighted the fact that research does not support food bans.
First generation treatments continue to have positive results in clinical trials, but questions remain. Moreover, no treatment for peanut allergies is currently approved by FDA or recommended by AAAAI. Even so, some allergists around the country have taken to providing in-office food allergy desensitization programs and a hotly contested Pro/Con debate was had at the conference. Those in the research world generally agree that there is risk in providing desensitization treatments in clinical offices due to potential differences in protocol, peanut protein amounts in foods purchased at retail, and lack of support for potential reactions after the office closes.
In peanut allergy treatment research, the most widely studied solutions continue to fall into one of three categories: oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous therapy (EPIT). The OIT most studied is AR101 (Aimmune Therapeutics). At AAAAI, sessions highlighted the success of OIT using AR101 to reduce the risk of anaphylaxis due to accidental ingestion, but stop short of calling it a “cure”. SLIT was presented in fewer sessions though research is ongoing. Meanwhile, new research was presented about the use of EPIT. Viaskin Peanut by DBV Technologies is the current most researched product for treating peanut allergies with EPIT and has been shown to be safe with few adverse reactions and high compliance. Next generation treatments were also discussed at the meeting, such as vaccines, but these are far from being available for clinical use.
On the whole, the AAAAI meeting highlighted the fact that food allergy research is a dynamic and exciting area of medical research.