Over the last few years there has been a lot of "good starts" when it comes to novel treatments of allergies and asthma. From a vaccine for cat allergies to bronchial thermoplasty for asthmatics, there have been a myriad of treatments, in varying stages of testing, that offer hope for the millions who suffer from environmental and food allergies as well as asthma. As the latest in this line, the FDA recently "fast tracked" a novel approach to desensitizing those with peanut allergies.
This new therapy is Viaskin® Peanut. From their website,
"Epicutaneous immunotherapy (EPIT®) consists in repeated application of antigen with Viaskin® on intact skin. EPIT induces a decrease of allergen specific responses (i.e. decrease of allergen-specific IgE, decrease of TH2 cytokine production, and decrease of local and systemic response after exposure to allergen) and increase of regulatory responses (i.e. increase of allergen-specific IgG2a or IgG4, increase of regulatory T cells (Tregs)."
In plain English, this is a patch that allows small but steady amounts of the peanut allergen (antigen) to be absorbed by the skin. This patch has a small air pocket built into it where it moisture condenses. This allows the antigen to combine with the moisture and be more readily absorbed by the skin. Langerhans cells, specialized immune system cells, capture the allergen in this outermost layer of the skin and migrate it to the lymph nodes. Here is where the modification (desensitization) takes places. As this process repeats it essentially trains the immune system to down-regulate and promote a long term tolerance of the allergen.
Upon reviewing the performance of the patch in earlier rounds of clinical trials, the Food and Drug Administration granted the patch a breakthrough therapy designation. This allows for faster development and review of the treatment. This the first drug designed for food allergies, that has received this designation. So why do certain treatments get this "fast track"? It all comes down to results. From adults to children as young as 12, test results show year long treatments with the patch resulted in patients demonstrating the ability to be exposed to at least ten times the amount of the allergen previously needed to elicit a response.
With this type of treatment, there are no painful shots or needles, or weekly appointments for sublingual drops. This patch bypasses traditional sublingual and desensitization treatments. There's also less risk to the patient actually having an allergic reaction since the allergen never reaches the bloodstream to trigger a full-fledged allergic response.
An easy way to visualize this is to think of a brownie. Before the treatment a patient may have an allergic reaction after eating a brownie that had a single, small piece of peanut in it. After the treatment, the patient could eat a handful of peanuts with no reaction. For those with food allergies, this kind of cushion can represent the difference between a trip to the emergency room after snack time and being just fine.
Now, with the FDA designation, there's a very real chance that this treatment could be available within in the next five years.
For more information on the clinical trials.
For more information on Viaskin and DBV Technologies.
Author: K. Gilmore
The team introduced Viaskin® Peanut, an epicutaneous immunotherapy (EPIT/ allergy patch), to encourage peanut tolerance via patches containing micro doses of peanut proteins. The epidermis is potentially ideal for allergen administration, as it is a safer route of allergen absorption in lieu of direct exposure to the vascularized circulatory system. Another factor that makes it prime location are the presence of Langerhans cells that specialize in antigen presentation. These act as "mediators of tolerance" for the immune system in the skin, and can be used in the favor of building peanut protein tolerances.
The year long therapy trial consisted of 221 peanut-allergic individuals who were treated with patches consisting of a various doses of peanut protein. All patients were tested at the beginning of the study to measure their initial peanut protein tolerance. After administering doses of the protein, ranging from 50 micrograms to 250 micrograms, their baseline test results were then compared to their tolerance levels at the end of the study.
Results showed that greater than 95% of the patients complied to the study (1% dropping out due to adverse affects) , and children treated with 250 microgram patches experienced a 19-fold increase in tolerance to peanut allergies! This means that at the end of the study they were able to tolerate 1 gram of peanut protein, the equivalent of 4 peanuts.
Viaskin® Peanut is the first of it's kind for combating food allergies, but initial results hint that it could be the first food allergy patch for other food allergies as well (seafood, tree nuts, soy, etc.). Beyond the patch itself, this study can also help us better understand how the body builds a defense for allergens. Understanding the mechanism is critical, particularly since food allergies are complex and usually require food avoidance, low dose immunotherapy or special diets. They cannot treated like environmental allergies such as pet dander allergies or pollen allergies, which can be treated with allergy shots, pills or sublingual immunotherapy (SLIT).
This EPIT therapy is promising for parents, patients, and practitioners. Food allergies are particularly challenging for parents who must constantly watch their younger children's diets, which can be strained in social or school related situations. Food allergies also affect nutrient intake, which can lead to potential growth hindrance and nutrient deficiency, as reported by the Journal of Academy of Nutrition and Dietetics. Practitioners may soon be able to give more options to patients, providing relief in fighting potentially lethal peanut allergies. We hope to see more advancement in this study, and see it become an accessible form of immunotherapy on the pharmacy shelves.
Author: R. Power
Wining and Dining
Restaurants can be risky business if you or your better half have food allergies. Cross contamination is often a problem with dining as even foods you may not be allergic to can be exposed to a variety of allergens (wheat, peanut, eggs, dairy, seafood, etc.) during preparation. Plus, finding a restaurant that is completely allergy free can be very difficult in less urban/metropolitan areas. Instead of worrying about food allergies on this special night, show of your amazing cooking skills and make a meal that best suits his or her diet. It will be a much more relaxing, far less crowded, and a much more enjoyable meal knowing that it’s allergy free and made from the heart. If you do insist of going out, you better have already made that reservation, and don't forget to bring along a few extra food allergy cards for the staff.
Boxed chocolates forewarn that they were made on equipment or in facilities that either process or have been exposed to common food allergens like nuts, eggs and dairy. There are chocolates out there that are allergen free and can be found on the web or at your local chocolatier (if you're not sure what a chocolatier is, see if you have a local one - a visit can be well worth it). There is even dairy-free chocolate available, made with substitutes like almond or rice milk. Another alternative is carob, a chocolate substitute made the seed pod of Cerotonia silique, a plant from the pea family. This substitute is caffeine free, naturally sweet and low in fat.
Gifts (Flower, Perfume, Stuffed Animals, etc.)
If you're well past your high school or even college years, these old standards are likely pretty cliché. A trip to your local grocery store on Valentine's Day will most certainly offer a veritable parade of procrastinating men, hurriedly picking up flowers, heart-shaped boxes of chocolate and stuffed teddy bears. The humor of that scene aside, all of these things can be potential triggers for allergies, asthma or chemical sensitivities. It's probably best to ignore the commercials. Don't listen to that Vermont Teddy Bear commercial telling you that on the top of a woman's wish list is an oversized stuff bear or a teddy in a biker outfit (I mean really?). Flowers can hold pollen and perfumes can be inappropriate for those with environmental allergies or chemical sensitivities. Save your money and check out my Romantic Alternatives this Valentine’s Day.
I can't think of many ladies (and even some gentlemen) who wouldn't want to be spoiled with some pampering. Nothing is as simple and classy as a nice set of manicured nails. With many local boutiques carrying "Five-Free" nail polishes, you can relax knowing that you aren't decorating your hands with formaldehyde, dibutyl phthalate (DBP), toluene, camphor or formaldehyde resin. Before you make your reservation though, call ahead to ask if they use any type of air cleaner or salon air purifier to keep down the odor/fragrance.
I don’t know anyone who's allergic to music. Buy some tickets and enjoy a night of entertainment and some dancing together. How much more romantic can you get?
Let's change gears a bit and highlight a couple ideas for the man in your life.
Take Him Out to a Ball Game
Any kinda game - soccer, football, rugby, baseball, basketball, hockey, wear his team's colors, steal his jersey and get hyped! And don't worry about giving back the jersey because you look better in it anyways. Around Valentine's Day, basketball and hockey are your best bets, and there are pro and college games of each.
Action packed fun that will test your shooting skills and pain tolerance (maybe a bit oversold, feels like a quick sting then it's gone). Partner up or compete against each other. Nothing says, "I love you" like zinging your better half with bunch of paintballs!
Unless he has celiac disease, brewery tours are a fun way to enjoy his favorite microbrew, and take home a new draft glass to your cupboard or mini bar! And if you don't like beer, it's ok because you're going to need a designated driver anyways.
Your activity or gift doesn't have to be extravagant, but that doesn't mean it has to be boring. Ultimately, these are just a few options to break away from some of the more run-of-the-mill Valentine's Day gifts. And by keeping in mind some of the pitfalls of allergies, asthma, or chemical sensitivities, you can not only share an enjoyable day/evening with your loved one but a safe one as well.
Author: R. Power
This question can be a very difficult one to answer. Alcohol, though consumed like juice, food, or soda (though your liver hopes not with the same frequency!), isn't governed by the same regulations or even the same agency as these others. While foods and most beverages fall under the domain of the Food and Drug Administration (FDA), alcohol falls under the guidance and regulations of the Alcohol and Tobacco Tax and Trade Bureau, a subdivision of the Department of Treasury. This INCLUDES labeling rules and regulations. So while your mega-jumbo-can-o-caffeinated-monkey-juice will most certainly have a label listing the nutritional value and all the ingredients, alcohol is almost always devoid of the former (and often the latter as well). Though it is often easier to determine how many calories are in your alcoholic beverage of choice, finding the actual ingredients that make up that drink is another story entirely.
Many producers do list ingredients on their website or have at least become savvy enough to list some of the common allergens that are NOT in their products, particularly nuts or nut derivatives. Beyond visiting websites and doing your own investigative research, many people are left with only anecdotal evidence as to whether a type of drink can cause a reaction or not.
Distilled spirits (think whiskey, rum, etc.) have a list of standard requirements when it comes to labeling. These include
- Alcohol Content
- Address of Distiller Country of Origin
- Net Contents (a metric measurement of volume)
- Coloring Agents (colored with caramel, annatto, etc.)
- Wood Treatment ("beechwood aged" ring a bell?)
- Other Ingredients like Dyes, (Yellow #5), Saccharin, or Sulfites
- Specific Type of Commodity (redistilled, blended, compounded, etc.)
- Statement of Age
- Distillation/Production Location
- A Health Warning
As of right now, major food allergens can voluntarily be listed for wines, distilled spirits, and malt beverages, but again, this is only voluntary. There has been a proposal to make this mandatory, and since 2006, nothing has been finalized... eight years later.
And, even if you do find a list of ingredients, this still may not cover a statement regarding the processing. Though some can tell you that there are no nuts in their products, many can't ensure their products were produced in a facility that is also nut-free. This touches on another problem, cross-contamination.
Bartenders and those mixing drinks work in fast paced environments and worrying about cross contaminating a drink is likely not high on the priority list when there are half a dozen orders rolling in at a time. A good general tip is to skip the garnish. One garnish in particular that can be troublesome for those with nut allergies is maraschino cherries. These are often processed or flavored with almond extract. If you know a favorite mix or type of drink that is safe for you and you order it with no garnish, you can dramatically reduce any risk. At that point ingredients should be coming straight from the bottle to your glass.
For reference purposes, here's a quick list of some common alcoholic beverages that contain nuts or nut extracts. Keep in mind, things can and do change, so contacting the producer is still your best bet.
- Creme de noyaux
- Creme de noix
- Kahana Royale
- Bombay Sapphire
- Harp Lager
- Phillips Dirty Squirrel
- Southern Comfort
This list is by no means comprehensive, and there are MANY varieties of wines, beers, champagnes and other types of alcohol I excluded because they to be rather obvious choices to avoid (many had things like "Nut", "Cashew", or "Almond" in the actual name).
In general, I advise people to stick with what they know. For people with severe nut allergies being adventurous around the holidays can likely lead to some not-so-festive memories. Check producers websites whenever possible, and if you don't see the information you need listed, call or email them. Most producers would much prefer you contact them and err on the side of safety when consuming their products. Lastly, make sure you keep your auto injector (and a backup!) handy at all times.
Unfortunately, all we've covered today is nuts. If you are one of the rare people who has a wheat or gluten allergy, that's a whole other ball of wax. Be safe and enjoy the holidays responsibly!
Researchers started by examining the role gut bacteria play in food sensitivities and food allergies in two groups of mice. Playing on the "hygiene hypothesis" researchers put together one group of mice that were raised in a sterile environment. In the other group, the mice were given a large dose of antibiotics at just two weeks of age. After being given peanut extract, both groups were observed, and from here researchers began introduction specific groups of bacteria to see if they had any effect on the allergic response. Specifically, Bacteroides and Clostridia bacteria groups were the focus, two types that are commonly found in wild mice.
The results were very interesting. First, mice that were given antibiotics showed a high sensitivity to the peanut extract. Antibiotics given early in life have recently been shown to be linked to a myriad of problems later on, including things like the development of allergies and asthma. Of the second group, the reaction to the peanut allergen was even more severe with some showing signs of anaphylaxis. While the introducing Bacteroides into the gut of mice had little effect, Clostridia was another story.
In both groups of mice, the introduction of Clostridia bacteria into the mice resulted in reduced allergic responses to the peanut allergen. This is extremely important for two reasons. First, it shows a link between specific gut bacteria and the development of allergies, again highlighting the link between the microbiome and the health of the animal. Second, these results point toward the potential of treating food allergies with the use of probiotics.
This study also refines the "hygiene theory" somewhat. While traditionally, it was suggested that a lack of exposure to germs and microbes early on could lead to the immune system overreacting to innocuous substances like dust mites, peanuts, or pollen, these results would suggest that a more sterile environment or perhaps even an overuse of antibiotics could lead to less diverse and less numerous gut bacteria, which would in turn be setting the stage for allergen sensitivity.
While the notion of treating allergies or food sensitivities with probiotics are still many years away, this latest research solidifies the link between gut bacteria and allergies. More importantly, it opens the door for potentially novel, new treatments of allergies, asthma and possibly other allergic diseases.
To read the abstract of this study.
Allergy-free peanuts? While it may seem a bit farfetched, this is just what they are working on. Started with a cashew extract (oil), researchers are treating the proteins found in the oil with heat and sodium sulfite. You may recognize sodium sulfite, as it's a preservative commonly found in a variety of foods. What this process does is change the molecular look of reaction-causing protein in the cashew, making it more difficult for immunoglobin (IgE - the antibody that kicks off your body's response, aka, allergic reaction) to recognize and bind with the protein.
Test results showed that when mixing unmodified and modified cashew proteins with the IgE of a nut allergic person, 50% fewer of the IgE molecules bonded with the altered proteins. This is important for a few reasons. Even though this isn't the first experiment to attempt this, it is the first that uses a compound generally regarded as safe (GRAS) to disrupt the protein structure of the allergen. It is also important because unlike other treatments, it is aimed at treating the food, not the person. Lastly, its success shows the potential for reducing or possibly even eliminating the binding of IgE to food allergens, the root of the allergic response.
For now results show a allergy-reduced nut, which isn't as helpful a non-allergenic one. However, these results at least point towards the possibility of this as a solution. What's up next for researchers? Modifying whole cashews then ensuring the cashews still taste they way they should! Until then, avoidance remains the best option for most dealing with severe food allergies.
To read the full abstract of the research.
For more information on food allergies.
Author: K. Gilmore
Eggs are used in wine production? All along I thought my glass of wine was made from grapes in a barrel sprinkled with some yeast. After doing some research, I discovered that not just eggs, but other fining agents are used to remove suspended proteins and solids from wine. These substances clarify the wine before being bottled. So while looking at my Riesling, I wonder if people with egg allergies are able to enjoy a little wine without fear of reactions.
So what are some of the fining agents used in the winemaking process? Here are a few of the most common things you might have never expected to be used in wine production.
- Egg Whites - The albumen found in egg whites is used to clarify red wines during barrel aging. This is the oldest fining method in winemaking.
- Chitosan - Composed of exoskeletons of crustaceans (shrimp, crab, shellfish), is a very common agent for finishing white wines.
- Gelatine (gelatin) - Derived from animal protein, it is recommended for red wines to help reduce excessive tannins and astringency.
- Isinglass - Made from collagen, a protein extracted from the swim bladders of fish. It's a very gentle fining agent, as it does not strip the flavor of the whites and blushes.
- Casein - Not necessarily used for fining, but used to clarify white wines.
For those who are highly allergic to lactose/dairy, eggs, or shellfish or for vegetarians and vegans, the best way to enjoy a bottle of wine without compromising your health is to check the labels, and try to stick with Old World wines (European). Cheers!
Author: R. Power
Halle Berry is one of the seven million people who cannot enjoy shrimp cocktails or a romantic lobster dinner, or any mollusks because of her shellfish allergy. Luckily this doesn't include Swordfish! Shellfish allergy symptoms can include hives, itching, swelling of the lips, face, tongue throat, or any body part, trouble breathing, stomach pain, dizziness, and even anaphylaxis. Unfortunately, many do not know they are allergic until they are adults.
Quirky Zooey Deschanel can only have oatmeal with almond milk for breakfast. Well, that’s what I would serve her, due to her lactose intolerance, celiac disease and egg allergy. Lactose intolerance and egg allergies can be hard on the digestive tract while celiac disease leads to the inability to absorb sufficient amounts of calcium and iron often leading to osteoporosis and anemia.
Let’s be grateful that Kim Kardashian is not allergic to latex. That would cut her wardrobe in half! However, she is allergic to cats. Approximately 10 million people are allergic to cats, making this the most common pet allergy in the U.S. What makes Kimmie sneeze and sniff is not the cat hair itself but the protein in the dander of felines.
Bouncing over to the world of sports, Serena Williams does not go to peanuts as a source of protein. Peanut allergies can cause anaphylaxis, wheezing, nausea and itching and tingling in or around the mouth and throat. Almond butter is a great alternative with high amounts of magnesium, iron and calcium.
And last but not least, Miley Cyrus could possibly be allergic to pants. Sadly, she can’t go anywhere that’s not similar to LA weather.
Have a great weekend, and enjoy the weather before another snow storm drifts our way!
Author: Rachel P.
Almond milk is a great milk substitute (1 cup of unsweetened almond milk contains 1 g of fiber and 30-40 calories!), with omega-3 fatty acids (important for mental health) and no lactose. Not only is it a great dairy milk alternative, but it also is helpful for those trying to reduce heart disease risks and watch their cholesterol intake.
So what is lactose intolerance? The Mayo Clinic explains lactose intolerance is due to the lack of lactase in the small intestine. This enzyme bonds to lactose molecules and breaks them down into glucose and galactose (simple sugars), to be absorbed into your bloodstream. Without lactase, foods with lactose move along unprocessed, thus leading to tummy aches and problems.
So Marsha can't enjoy pizza, quesadillas, crème brûlée or French toast, unless she puts a non-lactose spin on it. Breakfast is our favorite meal of the day, so I decided to share Marsha's favorite breakfast recipe. Bon Appétit!
French Toast (6 Pcs.)
- 2 Eggs
- 1 1/4 C. Almond Milk or 1 C. Almond Milk & 1/4 C. Coconut Milk
- 1/2 Tsp. Vanilla Extract
- Sprinkle of Cinnamon
- 6 Slices of Bread
- Coconut Oil or Vegetable Oil (Anything other than butter)
Next, place a knife’s tip of coconut oil on the pan and let it melt, which it quickly will, and spread over the pan. Place one slice in the pan, and let it cook on each side for about a minute and a half or brown to taste. Keeping the heat low can help to avoid burning your toast and scorching the oil.
Enjoy this delicious French Toast with fruit, powdered sugar (my mom uses blueberry sauce and powdered sugar) or maple syrup.
Come back and check out how we make crème brûlée sans heavy cream!
[Editor's Note: We would have a wonderful picture of this delicious French Toast, but our author ate it all. Poor show, Ms. Power, poor show.]
Author: R. Power
I have one general rule when it comes to handing out candy. I always give out things that I will want to eat if there's any left over. As I've gotten older, my sweet tooth has gotten larger, and this means not only stocking full-size candy bars but also suckers and gum balls. Having worked at AchooAllergy for several years, I've gotten into the habit of keeping things on hand that lack the nuts or dairy ingredients that can cause many food allergic kids problems. Some years I've also taken a handful of two dollar bills (the novelty never wears off on me) and put one each in a plastic Easter egg. On the big night, I bundle three suckers or six gum balls together, since in my mind, those are about equal to one candy bar. I keep each of these different types of things in different bowls and make up a little sign for each, i.e. "Diary-Free," "Dairy & Nut Free," and "Cavities Ahoy!"
This doesn't cover everything, but it does touch on some of the major food allergens. For me, it's not only important to have food allergic alternatives, but also for any kid who shows up at my doorstep not to feel slighted simply because they have a food allergy. Halloween is supposed to be fun, not disappointing!
Not everyone is going to take the time or effort to be so accommodating, and for many people food allergies are not something with which they have experience. So despite efforts that people do or do not take, here are a list of helpful tips that any parent of a food allergic child can keep in mind.
- Wait to Eat - As the most basic tip, try to avoid letting your child eat the candy while trick or treating. Wait until you get back home to not only tally the evening's sweet plunder but also sort out any potentially dangerous candy or sweets.
- Keep Your Own Stash - I like this tip! This is like your currency that you can use when the evening is over. As you sort and pick out any potentially dangerous treats, trade your child for a safe one from your stash. It's a win-win!
- Always Read the Label - Even treats that have been safe in the past can change, so always, always check the label. Avoid candy that is unlabeled, and if unsure, use the trade-in technique from above.
- Have Fun - Halloween is particularly loved by candy makers, but it isn't all about the sweets. Being in costume, visiting neighbors, and just spending time together can make the evening more fun and sweeter than any candy. If candy, and the possible problems from this, just seem like too much, go to party or host your own! There are always fun alternatives if you're willing to put in a little effort.
- Keep an Auto-Injector Handy - It always bears repeating, but keep epinephrine on hand when out and about.