Meredith Muirhead

AP Language and Composition

Period 3

26 March 2019

Where’s My Epi-Pen? Peanut Immunotherapy Can Help Us to Stop Asking

In elementary school, we all knew that kid who sat at the “food allergy” lunch table

in the back of the cafeteria. ​The Journal of Allergy and Clinical Immunology​ tells us that as

of 2017, 4% of Americans have food allergies, 3 million of which are peanut allergies. In

fact, the New York Times tells us that the prevalence of peanut allergies has increased more

than threefold in children just from 1997-2010. Food allergies require constant vigilance

whenever eating, along with carrying an Epi-Pen and some allergy medication whenever

leaving the home. Children with food allergies grow up the same way any child does, save

the fact that when they enter the world, they have to be conscious of every morsel of food in

front of them. The risk of having to handle allergic reactions from unknown sources is an

enormous factor in a decision to go away to college. As a result, immunotherapy is a solution.

Immunotherapy comes in three forms: OIT (oral immunotherapy), EPIT

(epicutaneous immunotherapy), and SLIT (sublingual immunotherapy). These forms are all at

different levels of safety. For those who aren’t ready to consume peanut protein despite being

supervised by a doctor, there is epicutaneous immunotherapy, where a patient wears a skin

patch that releases micrograms of peanut protein into the skin. For those who aren’t ready for

directly consuming peanut protein, there is the recent sublingual immunotherapy, which takes

longer but has the same results as oral immunotherapy. In sublingual immunotherapy, peanut

protein is dissolved in a liquid extract and placed under the patient’s tongue. Oral
immunotherapy is, so far, the most successful because it takes the least amount of time. In

oral immunotherapy, patients are given a gradually increasing amount (milligrams to grams)

of peanut protein to ingest in a doctor’s office. According to FARE (Food Allergy Research

Education), 33 of 33 participants surveyed in a clinical immunotherapy trial responded and

reported having been happy to have participated in the trial.

Immunotherapy, however, is not yet FDA approved. It’s not a flawless process-

FARE reported that there were 4 cases of epinephrine-treated anaphylaxis in a 2017 AAAAI

immunotherapy conference. However, it’s not as though patients are merely handed peanuts

and sent on their way. On the contrary, doctors oversee the every move of patients

participating in a trial. Just because the process is non-FDA-approved doesn’t mean that it’s

not life-changing and lifesaving. In the end, the greatest obstacle a patient has to overcome is

their own fear. They must consider the benefits of a life without paranoia and carrying an

Epi-Pen everywhere. Immunotherapy is like climbing a mountain-getting to the summit takes

time and strain, but there is a beautiful view at the top.