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Drew Bloomfield

Professor Leonard

English 1201

9 April 2022

A Cure for Food Allergies

Food allergies have been on the rise for many years; what is being done to find a cure?

As many as one in ten adults suffer from a food allergy in the western world (“Living with Food

Allergies”). I am one of those people. When I was just 18 months old, I was diagnosed with a

severe peanut allergy. I have spent my entire life checking labels, sitting at peanut free tables in

the cafeteria (away from my friends), and packing my own food for parties and restaurants. It

has often felt lonely, and I have been isolated from things that involve food due to my allergy. I

have struggled with anxiety throughout my life, as I am always worrying if what I am about to

eat is safe. The freedom of going out to eat with friends has been stripped from my social life, as

many restaurants are unsafe. In fact, many people without food allergies do not understand or

appreciate how dangerous food allergies are. For example, I have had teachers get annoyed

because my peanut allergy has been an inconvenience to them. Some even resented me because

they had to wipe tables and desks, and make sure peanuts were kept out of the classroom. In

Junior High, I was bullied by another student when he threw his peanut butter sandwich into my

lunch box. He was suspended, and on the report, it listed his “weapon” as a peanut butter

sandwich. Dating is tricky; the person I date has to be aware of my allergy, and abstain from

eating peanut products prior to our time together. In addition to all of this, I have to carry an

epi-pen (lifesaving mediation in the event of an allergic reaction), everywhere I go. As one can

see, food allergies are difficult to manage, and often cause secondary problems such as anxiety,
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isolation, eating disorders and bullying. In short, the fear associated with this disease can be

debilitating. A person with a food allergy struggles with the fact that they have to be extremely

cautious when it comes to eating anything. Essentially, they must eat to live, but at the same

time, certain foods could kill them. There is a lot of planning that goes into simple things like

going out to eat, going to a party, going to a concert or even who is safe to hug and kiss.

Currently, the best way to handle a severe food allergy is strict avoidance of the allergen, as

the various treatment options are risky, expensive, and fall short of a cure. Therefore, more

funding and research needs to take place to find a cure for food allergies.

Fig. 1. This shows the rapid increase in food allergies in the United States (“Living with

Food Allergies”).

Between the years 2007 and 2016, there was a 377% increase in anaphylaxis due to

allergic reactions to food. Currently, thirty-two million people in the United States suffer from

allergies to food, and a person visits the Emergency Room every three minutes due to an allergic

reaction related to food (“Living with Food Allergies”). There are many theories as to why this

rapid increase in food allergies has taken place, but no one has been able to find the cause. Some
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speculate the increase in food allergies comes from GMOs in our food while others attribute it to

vaccines, and some go as far as blaming anti-bacterial soaps, but none of these theories have

been proven.

“In the current era of medicine and molecular diagnostics (e.g., DNA sequencing of

tumors to look for mutations that match potential drug therapies to control cancer), our

ability to accurately and reliably diagnose our patients’ suspected food allergies is not

great. We don’t yet have easy tests that can provide clear, infallible answers and, in turn,

treatment plans and cures” (Gupta viii).

With millions of Americans suffering from food allergies, and a significant rise in anaphylactic

reactions with no reliable consistent solution to diagnose these ailments in patients, it is clear that

this growing safety risk is quickly becoming a major healthcare issue for our country.

A person can be allergic to anything; however, the top nine food allergens are: peanuts,

milk, shellfish, eggs, fish, wheat, tree nuts, sesame, and soy (Gupta 21). These are commonly

used foods, and are harmless to most people, but if a person who is allergic were to ingest one of

these foods, the reaction could be fatal. There are stories of this in the news all the time. For

example, a 13-year-old girl, Natalie Giorgi, died at a summer family camp after taking one bite

of a Rice Krispie treat that contained peanut butter. She immediately spit the bite out because it

tasted funny. Natalie’s father was a physician, and was at the camp with her. He immediately

administer an antihistamine and assessed that Natalie had no symptoms of an allergic reaction.

Natalie returned to dancing with her friends. However, twenty minutes later she collapsed on the

dance floor. Her father then administer the epi-pen three times, but it did not stop the

anaphylaxis. Natalie’s throat swelled shut. Her last words were, “I’m sorry” as she died in her

parents’ arms (Van Evra). As food allergies continue to trend upwards in this country and
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around the world, stories like this are unfortunately happening more and more frequently.

Therefore, one must hope for a cure of this horrible condition.

Fig. 2. This chart shows the percentage of insurance claims for anaphylactic reaction

between 2007 and 2016 (Gelburd).

Food allergies are the result of the immune system overreacting to a harmless substance,

and producing antibodies to attack the allergen. These antibodies can cause itching, watery eyes,

hives, running nose, and swelling of the throat (anaphylaxis). There are many things that can be

done to help improve your immune system, such as regular exercise, adequate sleep, reducing

stress, not smoking, limiting alcohol consumption, and washing your hands. In addition,

probiotics such as Lactobacillus Acidophilus have been shown to improve the health of the

immune system, as these good-gut bacteria can be related to overall health. Some studies even

suggest that probiotics paired with immunotherapy can provide better results than oral

immunotherapy in isolation (Gupta 216).

Our best treatments today come from the work of Leonard Noon. He was the first doctor

to try to treat hay fever by injecting patients with small amounts of pollen from grass. His

research took place in 1911, and is considered the first successful example of immunotherapy
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(Gupta 185). What is being done today to treat food allergies is much of the same. We have

made little progress in over 100 years with new advancements for this condition. More people

are being diagnosed and impacted by food allergies than ever before, which is why there needs to

be more funding, research, and progress to find a cure.

Currently, the most widely used treatment for food allergies is oral immunotherapy

(OIT). “The main goal of OIT is an increase in the allergen reactivity threshold to achieve lower

risk of severe allergic reactions after accidental ingestion” (Akarsu et al.) Oral immunotherapy

is the process by which small amounts of the allergic food are given to the patient to desensitize

the allergen. Desensitization is an approach that allows the patient to slowly increase the amount

of the allergen required to trigger an allergic reaction. Over time, the patient is then able to

tolerate small amounts of the allergen, like a single bite, without having an allergic response.

In OIT treatment, allergic food is introduced at the doctor’s office, and then small amounts are

given at home each day. The patient must return to the doctor each week to increase the dose.

This treatment does not cure the food allergy, but it often leads to a tolerance of a small amount.

However, some patients suffer from anaphylaxis, a severe, potentially life-threatening allergic

reaction, when participating in this treatment, making this treatment risky for many with a more

severe form of allergy.

Oral immunotherapy has several potential side effects ranging from mild to severe. The

side effects were reported in both the build-up phase and the maintenance phase of the therapy.

“A rare but important side effect of OIT is eosinophilic esophagitis [esophagus becomes

inflamed and does not contract properly] with a frequency rated at 0.3%... [in addition] 8.3% of

patients experience gastrointestinal symptoms during OIT. Further, two meta-analysis reported

that OIT increases anaphylaxis risk and frequency of adrenaline [epinephrine] use… two cases of
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lethal reaction to intentional introduction of a food are reported” (Akarsu et al.) A tragic

example of this was when nine-year-old, Brooklyn Secor, of Ontario Canada, died shortly after

eating her maintenance dose of baked milk (in the form of a muffin bite) during her medically

supervised oral immunotherapy treatment (Mondello). However, successful OIT can lower food

related anxiety, and increase one’s food related social life, but it comes with risks.

New clinical research is able to determine failure or success of oral immunotherapy prior

to the treatment beginning by studying the gene modules in a particular patient. “Not all patients

respond to OIT, and there is a high likelihood of regaining sensitization to peanuts after cessation

of treatment. It is important, therefore, to identify biomarkers that impact and predict OIT

outcomes” (Cao and Nagler). Essentially, they are studying the gene modules to figure out why

certain patients respond well to the treatment while others do not (Cao and Nagler). Having this

information before beginning oral immunotherapy will help the patient decide if this treatment is

worth the risk. Although this treatment is widely used, one may not consider it a cure, since you

must still avoid the allergen and are only protected against an accidental bite. This can bring a

much-needed mental reassurance to many, yet still is not an ideal therapy due to the high risk

nature for some.

Epicutaneous immunotherapy (EPIT) is another form of treatment. This is similar to oral

immunotherapy but instead of oral ingestion of the allergen, you wear a patch on the skin that

contains the allergen. The patches contain different amounts of the food protein, and the

treatment allows you to increase the length of time, and the amount of protein on the patch under

medical supervision. EPIT patches are in clinical trials for egg, milk, and peanuts. The results

of these trials is promising (Gupta 189). However, like oral immunotherapy, one would not
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consider this a cure since it only provides a small amount of protection against an allergen, and it

too comes with the risk of a reaction.

Another treatment for food allergies is Sublingual Immunotherapy (SLIT). Sublingual

involves a small amount of the allergen placed under the tongue for absorption before being

swallowed or spit out. Like other forms of immunotherapy, you start with a small amount or

“dose” and gradually increase the amount every two weeks, until a maintenance dose is reached.

This too is done under a doctor’s supervision (Gupta 187). The goal of this treatment, like the

others, is desensitization rather than a full cure.

In January of 2020, the FDA approved the first peanut allergy drug. This drug, Palforzia,

essentially takes oral immunotherapy and turns it into a pill form. Each pill contains a small

amount of peanut flour, and patients take them in increasing doses per their doctor’s instructions.

Once again, this is not a cure, but allows the body to tolerate a small amount of the allergen

before reacting. This makes it so the patient would not have to worry about accidental

consumption of small amounts (Johnson). Yet, “the drug can cause severe allergic reactions and

require epinephrine injections. It’s unclear how long patients will have to stay on the drug”

(Johnson). Johnson goes on to state that if the maintenance dose is discontinued then the patient

would not have any protection against the allergen. Therefore, to maintain the desensitization,

patients may have to stay on the drug for life. One has to wonder if the risk and inconvenience

is worth the outcome.

Microneedle delivery may be a way to improve immunotherapy. Researchers found that

delivery of the peanut protein via microneedle produced superior results compared to a skin

patch or oral administration. The study was conducted on peanut allergic mice. “Mice that were

treated five minutes per day with the peanut-coated Microneedle device had significantly
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enhanced desensitization, providing protection from reactivity following a peanut challenge.

The results were achieved despite the microneedle therapy applying a dose of peanut protein ten

times lower than the dose delivered by EPIT [peanut patch] (Shakya et al. 38). These positive

results on animal tests suggest future trials to evaluate the effectiveness on humans with peanut

allergies. Yet once again, this treatment does not address the underlying cause, that creates an

allergic reaction by the person’s immune system. It is simply another form of desensitization,

and not a cure.

Epicutaneous Immunotherapy (EPIT), Oral Immunotherapy (OIT), Sublingual

Immunotherapy (SLIT), and the FDA approved drug, Palforzia, have their short comings. All of

these treatments have caused severe allergic reactions in patients, requiring epinephrine, and on

occasion have even resulted in death (Gupta 195). In addition, Palforzia costs $890 per month

when you can buy the same peanut flour that is in the capsule for a few dollars (Johnson).

Although these treatments are currently widely accepted, research is still being done to find a

better solution. Unfortunately, the treatments to date are more of a “band-aid” approach verses a

curative solution that gets to the root problem.

There are many newly designed biologics being studied for food allergies that are

currently in clinical trials and are showing positive results. There are two drugs, Xolair and

Dupixent, both are anti-IgE monoclonal antibodies, “that have been shown to block certain

inflammatory activities in the body that fuel allergic reactions” (Gupta 194). These relatively

new drugs are typically prescribed for asthma, but one day they may be used for food allergies.

The good news is, these particular drugs do provide a different approach in treatment verses the

desensitization protocols whereas their mechanisms of action are at least attempting to address

the IgE allergic response cascade. In addition to these biologics, probiotics have been shown to
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increase the effectiveness of oral immunotherapy (Gupta 194). Finally, research is underway to

genetically engineer food to change the protein that triggers an allergic reaction (Kamath). The

research to genetically engineer food may in fact be risky, as some attribute the current rise of

food allergies to our already overly genetically modified food supply. Therefore, you may cure

some food allergies by genetically altering the protein that causes the allergy, but you may

unfortunately, inadvertently cause another, or several other, significant and potentially severe

health problems in the process.

One might argue that the current funding and research for food allergies is sufficient.

Many contend that desensitization programs, protocols, and therapies have made a significant

enough improvement to establish these therapies as best practices. People who used to fear

every bite they took are now able to eat foods that are processed with or contain traces of an

allergen, without the risk of symptoms. This progress is due to the research and work in the area

of oral, epicutaneous and sublingual immunotherapies. Some see this as a huge stride and

accomplishment in the food allergy world. People who were once isolated are now able to sit

with their friends at lunch, able to eat at any restaurant, and go to parties with friends.

However, if you look at the amount of money invested in the research of other ailments

such as heart disease, cancer, Alzheimer’s etc., it is clear that much more time, energy and

resources are placed in these areas verses food allergy research. Unfortunately, as with most

things in life and business, if the perception that not enough money will be made on products

created by the research, then many companies do not feel compelled to invest the research and

development dollars necessary to truly solve problems like food allergies. On the other hand,

though the increasing nature of food allergies is problematic, it is at least shining a brighter light
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on the market potential for promising therapies, which will in turn, incentivize companies to be

willing to risk the money in research.

There are many current treatments for food allergies, but none are a cure. To most

people, the word cure means to rid oneself of a condition or disease. A cure for food allergies

would be when patients do not have to sit at a separate table at lunch. When they eat whatever

food they want at class parties, birthday parties, and field trips without worrying about a trip to

the emergency room. A cure would mean that patients did not have to carry an epi-pen

everywhere they went. Current immunotherapy treatments might suppress the symptoms if only

small amounts of an allergen are ingested, but a true cure would allow a person to eat as much as

they want with no symptoms, eliminating the allergy altogether.

Will there ever be a cure for food allergies? People with food allergies experience

anxiety, bullying, isolation, and even eating disorders. “It’s an endless loop of pondering,

planning, worrying, deciding and dealing” (Gupta 176). The current and most widely used

treatment today is oral immunotherapy, or in the case of peanut allergies, the new Palforzia pill.

These treatments are both risky and expensive. In addition, they do not cure the allergy, they

only allow for tolerance of a small amount. Lastly, one of the bigger issues plaguing people with

food allergies is the constant anxiety and fear that comes with the uncertainty of many of the

foods we eat every day. Couple this with the general lack of understanding, and empathy from

those without food allergies, it makes carrying the burden of these allergies even greater as it

adds not just the physical dimension, but the emotional and social aspects as well.

With approximately 32 million Americans suffering from food allergies, and the number

of cases being diagnosed increasing every year, we must be more committed as a society to find

cures for those who suffer from one of these potentially life-threatening allergies. It is
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inadequate to just continue finding new ways for desensitization protocols that help some, but

place others at further risk. We must find the resolve to put the funding into the proper research

to find a cure for these allergies, not in the pursuit of further profits for drug makers, but in the

ultimate pursuit of taking care of our population.

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Works Cited

Akarsu, Aysegul et al. “Oral Immunotherapy in Food Allergy: A Critical Pediatric

Perspective” Frontiers in Pediatrics, vol.10, 22 Feb. 2022,

https://www.frontiersin.org/article/10.3389/fped.2022.842196 .

Cao, Shijie, and Cathryn R. Nagler. “Interpreting Success or Failure of Peanut Oral

Immunotherapy.” Journal of Clinical Investigation, vol .132, no. 2, 15 Jan 2022,

p. NA. Gale in Context: Opposing Viewpoints,

link.gale.com/apps/doc/A691458533/OVIC?u=dayt30401&sid=bookmark-

OVIC&xid=486f8ba9. Accessed 27 Feb. 2022.

Gelburd, Robin. “Food Allergies: New Data on a Growing Health Issue” Real Clear

Health, 21 Aug. 2017,

https://www.realclearhealth.com/articles/2017/08/21/food_allergies_new_data_on

_a_growing_health_issue_110709.html.

Gupta, Ruchi. Food without Fear: Identify, Prevent, and Treat Food Allergies,

Intolerances, and Sensitivities. DA CAPO PRESS INC, 2022.

Johnson, Carolyn Y. “First Peanut Allergy Drug Approved by FDA.” The Washington

Post, WP Company, 1 Feb. 2020,

https://www.washingtonpost.com/health/2020/01/31/first-peanut-allergy-drug-

approved-by-fda/.

Kamath, Sandip. “Food Allergy: Playing the Game of Chance.” YouTube, uploaded by

TED, Dec. 2018 https://www.youtube.com/watch?v=ksA1NWNkdoQ&t=1s

Accessed 26 Feb. 2022.

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“Living with Food Allergies.” Food Allergy Research & Education, 26 Jan. 2022,

https://www.foodallergy.org.

Mondello, Wendy. “Girl with Milk Allergy Dies of Severe Reaction Related to

Desensitization” Allergic Living, 20 Dec. 2021,

https://www.allergicliving.com/2021/12/20/girl-with-milk-allergy-dies-of-severe-

reaction-related-to-desensitization/.

Shakya, Akhilesh Kumar, et al. “Microneedles Coated with Peanut Allergen Enable

Desensitization of Peanut Sensitized Mice.” Journal of Controlled Release, vol.

314, 2019, pp. 38–47., https://doi.org/10.1016/j.jconrel.2019.09.022.

Van Evra, Jennifer. “Lessons From a Teen Food Allergy Tragedy.” Allergic Living, 22 Aug.

2013, https://www.allergicliving.com/2013/08/22/lessons-from-a-teen-food-allergy-

tragedy/.