For many Canadians with food allergies, the slightest contact with an allergen can put them into anaphylactic shock. But researchers are now learning so much about food allergies, some believe there could actually be a cure within a decade.
Dr. Adelle Atkinson from the department of immunology and allergy at the Hospital for Sick Children in Toronto says research has accelerated worldwide in recent years.
"It's a really exciting time to be working in our field," . "Even when I was training, I couldn't have imagined what it would look like today for our patients."
Atkinson says given the pace of advancements in her field, the prospect of a cure within 10 years now seems realistic.
"It's a lofty goal I think, but it's something we're working toward and there are a number of things going on," she said.
One of the researchers on her team, for example, is working on a molecule that appears to be able to predict if a child will have a severe reaction to a particular food.
"And if one could potentially block that molecule, we might be able to decrease the severity of a reaction," she explained.
That could lead to a medication to prevent severe reactions one day. While such a therapy wouldn't be a cure, it would ensure those who are severely allergic won't go into anaphylaxis after being accidentally exposed to an allergen.
De-sensitizing
Another area of promising research focuses on desensitizing, in which those with severe allergies are exposed to minute amounts of the allergen, which is then increased slowly over time to encourage a tolerance.
The goal is not to get the child to the point they could comfortably eat the food, but to train their immune system to handle the exposure better so they don't mount such a severe reaction.
Atkinson says her team also wants to better understand why some kids develop only mild allergies to certain foods, while others develop severe reactions.
"We're working on also looking at the genetics. What are the genetic underpinnings? How can we predict which kids will have a more severe reaction, and then potentially intervene in a different way?" she said.
Understanding how each child's reaction is different could lead to a more "personalized medicine" approach to treatment, .
'De-labelling' allergies
Along with research, Atkinson's clinic also works on ensuring that kids and their families get clear answers on whether they really have food allergies.
She says there are many kids who are misdiagnosed after an odd reaction or even a positive skin test. She says her clinic works to "unlabel" as many of these kids as they can.
"It has huge implications on how they live. So we feel very strongly that those kids should be seen by an allergist and potentially challenged (meaning undergo a food sensitivity challenge) to prove they have the allergy," she said.
As well, since most kids will outgrow allergies to many foods including milk, eggs, and wheat, her clinic regularly tests kids to see if they retain these allergies as they age.
Better understanding on prevention
Finally, allergists are making great strides in understanding how to prevent food allergies in the first place.
For years, doctors assumed that kids considered at high risk for allergies because of a parent or sibling with an allergy should avoid certain foods. The idea was that would allow the immune system to mature and perhaps tolerate the food better.
"Now, we understand it's probably the opposite and that's a really important breakthrough in our field," said Atkinson.
As explained in a long-term study , early introduction of potentially allergenic foods to high-risk children seems to actually prevent a significant number of children from developing allergies.
That study has led doctors to conclude that the recommendations they made 10 or 15 years ago to delay the introduction of allergenic foods may have inadvertently caused an increase in the incidence of food allergies.
Pediatricians now recommend that even commonly allergenic foods should be introduced to babies as soon as they begin eating solid foods, at approximately six months of age.
"We now know that delaying allergenic foods such as milk and eggs in any child – and particularly in high-risk kids... is not the right thing to do."
