Living with peanut allergies can be terrifying, but soon a new technology may be available to free these individuals from the constant risk of developing anaphylactic shock. Invented by a team of researchers from Johns Hopkins University, the University of North Carolina, Mount Sinai, and the University of Arkansas, the Viaskin® Peanut Patch, a wearable skin patch, may finally treat peanut allergies once and for all. Last week, the team unveiled the highly anticipated results of their clinical trial in the Journal of Allergy and Clinical Immunology.
The peanut allergy is one of the most common food allergies in the world and can manifest as a simple inconvenience or a potentially fatal medical condition. Approximately three million Americans are allergic to peanuts and tree nuts, and the number of children allergic to these food products has tripled over the last decade. The exact causes of these allergies remain unknown, but immunogenetic and environmental factors are thought to play a role.
The Viaskin® Peanut Patch, manufactured by DBV Technologies, works by administering small doses of peanut protein through the skin over time to help accustom the immune system and prevent future allergic reactions. This vaccine-like approach has been shown to be safe and highly effective in protecting children and young adults with peanut allergies from severe allergic reactions upon accidental ingestion or exposure to peanuts.
“This is exciting news for families who suffer with peanut allergies because Viaskin represents a new treatment option for patients and physicians,” stated Hugh A. Sampson, Director of the Jaffe Food Allergy Institute at the Kravis Children’s Hospital at Mount Sinai.
To test the safety and efficacy of the Viaskin® Peanut Patch, researchers performed a clinical trial involving 221 volunteers between the ages of four and twenty-five. To measure baseline peanut tolerance, or the amount of peanut protein they could ingest safely, these volunteers were given an oral peanut challenge. They were then given one of three patches: a high-dose patch containing 250 micrograms of peanut protein, a low-dose patch containing 100 micrograms, or a placebo patch containing no peanut protein. A new patch was applied daily over a year.
After one year, the volunteers’ peanut tolerance was retested. Approximately 46% of individuals treated with the low-dose patch developed a higher peanut tolerance, and over 48% of individuals given the high-dose patch also experienced therapeutic benefits.
“After one year of therapy, half of the patients treated with the 250 ug patch tolerated at least 1 gram of peanut protein – about four peanuts —which is 10 times the dose that they tolerated in their entry oral peanut challenge,” explained Sampson.
Children between the ages of four and eleven reaped the greatest therapeutic benefits. In fact, children treated with the high-dose patch developed a nineteen-fold increase in levels of an antibody, peanut-specific IgG4, which is associated with peanut tolerance.
These new allergy patches represent a class of therapies called epicutaneous immunotherapy, which has been shown to be more effective than the traditional oral immunotherapies in inducing allergy resistance, especially for children. Oral intake immunotherapies have also found to be challenging to administer in 10-15% of adults.
“To avoid potentially life-threatening allergic reactions, people with peanut allergy must be vigilant about the foods they eat and the environments they enter, which can be very stressful,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in the National Institutes of Health (NIH) statement. “One goal of experimental approaches such as epicutaneous immunotherapy is to reduce this burden by training the immune system to tolerate enough peanut to protect against accidental ingestion or exposure”.
The patch was designed to be extremely user-friendly and causes minimal discomfort. In adults, the patch is applied to the upper arm, allowing easy application and removal; in children, the patch is applied between the shoulder blades. Moreover, there are no indications of serious side-effects associated with patch. The patch has not yet been approved by the U.S. Food & Drug Administration and is still undergoing clinical trials conducted by the Consortium of Food Allergy Research and the NIH.
Dr. Jennifer Shih, an assistant professor at Emory University School of Medicine who specializes in pediatric allergies, made sure to state that although the peanut patch study is promising, it is not a cure.
“This (patch) is not so that somebody can eat a bunch of Reese’s for Halloween,” she said, but those who use the patch are “hopefully protected from accidental exposure” to peanuts.
Hopefully, further investigation of this novel therapy will allow the peanut patch to become commercially available within the next two years and provide some relief to those with severe peanut allergies.
Though this patch may not be a cure, it will definitely transform the lives of children and adults living with these allergies.
Sabrina Leung ‘18 is the Digital Editor majoring in International Relations-Political Science with a minor in History. She is best reached at firstname.lastname@example.org or @sabrinatzleung on Twitter.