Treatment for food allergy
Current treatment for FAs is total avoidance and rescue treatment such as epinephrine injection in the event of inadvertent exposure. Some allergies have been treated by allergen-specific immunotherapy (SIT), where patients receive monthly injections with allergen extracts for 3 to 5 years. However, SIT cannot be used to treat food allergies because of the severity and unpredictability of reaction. For treatment of allergic asthma, immunotherapy via the subcutaneous route is very effective. The FAST (Towards safe and effective immunotherapy of persistent life-threatening food allergies) project has worked to find effective treatment solutions for FAs. A vital point that researchers needed to address was to make the allergens less potent before using them for testing in clinical trials in multiple centres. The correct strength for efficacy must also be taken into consideration. Fish allergy is linked to parvalbumin and the FAST project has modified the allergen using biotech techniques. They successfully developed a candidate vaccine with an improved safety profile. This vaccine was tested in a first-in-man two-centre Phase I/IIa safety trial on fifteen patients. This was followed by testing in six countries in a Phase II trial with forty-one patients. In both trials, the vaccine proved to be safe, well-tolerated with no severe side-effects. Treatment induced a significant quantity of IgG antibodies in patients with fish allergy. Efficacy was assessed mainly by measuring the threshold for fish in a double-blind placebo-controlled food challenge. Half the patients showed subjective symptoms and the other half had objective symptoms. Patients with subjective symptoms showed a strong improvement on placebo itself, rendering group analysis inconclusive. So, the team analysed the patients with objective symptoms separately. Active treatment increased the threshold although a bigger sample size is required for this result to be significant. FAST project results for fish allergy show promise and the team is of the opinion that further studies are warranted, particularly in children. Child and adult nutrition is affected by allergies to fish, a key part of a healthy diet. Using FAST data as a sound knowledge base, further research could be successful in finding a safe solution to FAs that will solve a major problem with nutrition due to diet limitations.
Keywords
Treatment, food allergy, allergen, FAST, clinical trial
