Now We Have Options: Exposure Treatment Lifting Burden of Severe Allergies

Severe food allergy is among the few conditions that can propel a person from robust health to unconsciousness within minutes, and the risk of accidental exposure often casts a shadow of anxiety.

- Hannah Devlin

But change is afoot, with a groundbreaking trial this week showing that two-thirds of adults with severe peanut allergies can be desensitized through clinically supervised daily exposure. The approach—oral immunotherapy—is already successfully used in children and is among a wave of treatments on the horizon aimed at reducing the burden of allergies—or in future potentially curing them.

"Up until 15 years ago we never offered anything other than complete avoidance and carry your epinephrine," says Prof Robert Wood, director of pediatric allergy and immunology at Johns Hopkins University. "Now we have options."

The surge of interest in treating allergies has been motivated, in part, by an unprecedented rise in prevalence. Food anaphylaxis admissions to UK hospitals increased threefold from 1998 to 2018, according to one analysis, and the number of people affected by less severe allergies has also risen significantly, with factors including weaning practices, detergents, and lack of childhood contact with dirt and animals all potential drivers.

Exposure as treatment is not a new idea: the first successful use of oral immunotherapy for a 13-year-old boy with egg allergy was reported in the Lancet in 1908.