The future of food allergy? The emergence of targeted allergy treatments
Rachel Arthurs explores how public exposure to the complications of food allergy has affected attitudes toward treatment
In recent years, there has been a noticeable shift in the increased public awareness of allergy-related complications both within the United Kingdom and globally. In 2010, Allergy UK estimated that at least 44% of British adults were currently suffering from at least one allergy, a statistic that only continues to rise steadily each year. In the United States, Statista reported that approximately 20% of American adults in 2017 were suffering from an allergy or food intolerance. The growing interest in allergy shown by the British public was further amplified by the widespread outrage in 2017, following an incident in which a teenage customer of a popular British sandwich chain experienced anaphylaxis as a direct result of inadequate allergen labelling. This is not an isolated incident, but a constant fear and source of anxiety for allergy sufferers all over the world.
This growing concern for public safety, especially for young children who are more vulnerable to accidental exposure, has prompted many within the biotech industry and amongst concerned parents and charities to investigate what can be done to lower the risk to life.
Whilst there is clear social interest in the preventative treatment of food allergy and anaphylaxis there is currently no drug present on the market approved and available for widespread use. Although, this form of treatment may become widely accessible much sooner than we think. With drugs in the pipeline aiming to minimise severe reactions expected to become available to the public within the next two years, it is undoubted that there will be considerable interest from those suffering with allergies and intolerances.
Currently, as seen in the guidelines published by the National Institute for Health and Care Excellence, patients under the age of 19 must undergo an allergy-focused clinical history test before the diagnostic process can take place. From here, a food elimination diet may be suggested before referral to a specialist for monitoring and the prescription of an EpiPen (epinephrine autoinjector). Doctors have adopted an strict avoidance approach for many years without much progress in the field. However, potential therapies such as oral immunotherapy and patch immunotherapy are on the horizon, utilizing the immune system to recognize and neutralize certain illnesses following controlled micro-dose exposure.
Concerning pipeline drugs, there are some exciting new treatments in development. Currently, there are both preclinical and clinical toxicity studies taking place to investigate the future of a next generation food allergy immunotherapy . The most popular and anticipated treatment comes in the form of food oral immunotherapy (OIT) which consists of closely monitored, gradually increasing ingested doses of allergens being introduced to the patient. As doses are increased, the patients’ immunity to their allergen will simultaneously decrease.. According to Michael H. Land, this form of treatment has shown very promising results and recent presentations have displayed evidence that OIT does, at a minimum, temporarily desensitize patients. Other pipeline treatments include food sublingual immunotherapy (SLIT), which is administered in liquid form under the tongue and epicutaneous immunotherapy (EPIT) which is administered by patch meaning the allergen is released in small amounts through the skin over time.
In addition to immunotherapy, the use of probiotics is now being investigated as a means of altering sufferer’s immune systems through gut bacteria. Allergy antibody medication or ‘anti-IgE’ is also being studied for its potential as a combination therapy alongside OIT treatment. Anti-IgE has long been approved in the treatment of asthma and other allergy-related conditions as it targets the bodies IgE antibodies. Whilst these techniques all show promising results for the future of allergy treatment, there remains room for investigation with regard to the permanence this desensitization has on the body as well as long-term efficacy.
By building a tolerability to allergies such as those sensationalized in the British media, we can think forward to a time where reducing the severity of anaphylactic reactions is a viable option for these patients. But from a biotech and pharmaceutical perspective, it will be very interesting to witness just how far the possibilities of this emerging clinical market can go.
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