When Porter Hall of Raymore, Missouri, was a year old, he broke out in hives after eating a spoonful of peanut butter. It led to a scary night in the emergency room and a diagnosis of peanut allergy.
But today, Porter, who?s now 5, is giving peanuts another shot with the help of Kansas City doctors, who have been giving him tiny doses of peanuts over the course of months.
This oral immunotherapy treatment isn?t a cure, but doctors say these tiny exposures may help to reduce or prevent severe reactions ? although some critics are warning families to consider the risks.
At Children?s Mercy Hospital in Overland Park, nurse practitioner Jodi Shroba gives Porter a quick once-over in preparation for administering a tiny dose of what?s essentially peanut dust.
Like many parents dealing with a child?s allergy, Porter?s mother, Amy Hall, says she was initially ?freaked out,? and took dramatic steps to keep peanuts away, including purging the contents of her kitchen cabinets.
Shroba says this fear can make the exposure sessions terrifying for parents and children alike.
?You see the anxiety,? Shroba says. ?They gotta kind of psych themselves up for it, and they?re like, ?I can do this. I can do this.??
Children?s Mercy doctor Jay Portnoy explains that gradually increasing exposures are meant to reduce severe reactions by exhausting the immune system?s of chemicals like histamine that lead to those reactions.
Children?s Mercy Hospital nurse practitioner Jodi Shroba gives Porter Hall a checkup before a peanut allergen exposure session. KANSAS NEWS SERVICE/ALEX SMITH/KCUR.ORG
?Mini-reactions?
?We?re creating like little mini-reactions that are so small that the patient doesn?t notice it. Occasionally, they?ll get itchy mouth, they might get a little bit of stomach ache, but for the most part, these reactions are definitely tolerable, and then as we increase it, they become more and more tolerant of the peanut allergen,? Portnoy says.
After six months, Portnoy says patients may be able to tolerate a few peanuts at a time, if they keep the exposures going.
Right now, the treatment is only offered at a limited number of hospitals and clinics around the country. But it may be on the verge of taking off.
The Food and Drug Administration is now reviewing AR101, a kind of medical-grade peanut flour produced by drug maker Aimunne Therapeutics that was tested at Children?s Mercy and other hospitals.
And a research review recently published in The Lancet shows that oral immunotherapy appears to work. At least it does in clinics, where patients have been able to overcome food allergy challenges.
But one of the study?s authors, allergy researcher Dr. Derek Chu of McMaster University in Hamilton, Ontario, notes that things can change after they leave.
?Outside of the clinic setting, they actually have a much higher rate of reaction,? Chu says. ?That?s two to three times more likely to react to peanut or the dose that they are exposed to during this desensitization procedure compared to avoiding it or receiving a placebo instead.?
