There’s new hope for children with peanut allergies as Australian researchers discover vital immunological changes that support the remission of these sometimes fatal allergies. As a result of their findings, they have paved the way for new and more targeted immunity treatments.
The research found that for the first time, specific gene networks have been rewired to ‘drive the transition from peanut allergy to clinical remission’ after using a combination treatment that included a probiotic and peanut oral immunotherapy.
The study was led by the Murdoch Children’s Research Institute (MCRI) and the Telethon Kids Institute. What they discovered is this network reprogramming basically shuts down the allergic immune response that is actually responsible for causing the food allergy in the first place.
Murdoch Children’s Professor, Mimi Tang, who is also the lead researcher in the study, said that this was the very first study ‘to map the complex gene communication and connectivity underlying clinical remission of peanut allergy.’
She said, “The immunological changes leading to remission of peanut allergy were largely unknown.” Former studies focused more on examining the levels of gene expression, but they didn’t look into the way genes interact with each other. However, genes don’t work in isolation, but rather, biological responses are controlled by considerable numbers of genes that communicate with each other, which is why it made sense to look further into these interactions.
“What we found was profound differences in network connectivity patterns between children who were allergic and those who were in remission. These same changes were also seen when we compared gene networks before and after immunotherapy in the children who achieved remission following immunotherapy,” Professor Tang added.
The randomized yet controlled trial involved 62 children with peanut allergies aged 1 to 10 years from Melbourne, Australia. They were given a combination treatment that included a probiotic and oral immunotherapy, which included the gradual introduction of the allergenic food, or a placebo. After 18 months of treatment, 74 percent of the children taking the combination treatment reached remission as compared with the 4 percent in the placebo group.
The peanut oral immunotherapy used in the trial hand in hand with the probiotic was PRT120, which is a lead candidate from Australian biotech company, Prota Therapeutics. The company focuses on bringing its new allergy immunotherapy treatment for kids with life-threatening peanut allergies to the market.
Led by Professor Tang, the team recently showed in another trial two treatments, ‘the combination probiotic and peanut oral immunotherapy treatment and the peanut oral immunotherapy alone,’ were considered highly effective at inducing desensitization and remission. Incredibly, around half of the treated children reached remission, allowing them to stop the treatment and eat peanuts safely and freely.
According to Dr. Sarah Ashley of Murdoch Children’s, although the oral immunotherapy may successfully induce remission and desensitization, the desensitization often waned after the treatment ended, or in fact, even during the ongoing maintenance dosing.
Dr. Ashley shared, “Certain changes in the allergen-specific immune cells, called Th2 cells, are critical to achieving lasting remission. Th2 cells are essential for generating allergen-specific antibodies and the development of food allergy. We found that the Th2 signaling that drives allergy is ‘turned off’ in children in remission.”
Notably, food allergies are a global public health concern that affects at least 10 percent of infants, and 5 to 8 percent of children.
Dr. Anya Jones from Telethon Kids Institute said that since there is no cure for food allergies, food allergy management mostly relied on the children’s avoidance of the food they are allergic to, which was considered a reduction of their quality of life.
She went on to explain, “Understanding the complex immune processes that support remission will provide greater insight into key drivers of treatment success and potentially identify novel targets for more effective treatments that deliver long-term solutions for patients.”
The study was published in the journal Allergy.
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