New Hope for Pollen, Milk Allergies
Shorter Course of Allergy Shots, Skin
Patch for Milk Allergies Among New Approaches
By Charlene Laino
WebMD Health News
Reviewed by Louise
Chang, MD
March 18, 2009 (Washington, D.C.) -- Whether you're
allergic to pollen or food
, help is on the horizon.
Doctors report early success with a new approach that shortens the course of
allergy shots for people allergic to ragweed and grass. Other researchers found
that an experimental skin patch may help children who have milk allergies.
Other dairy-allergic children are benefiting from a
counterintuitive therapy
in which patients swallow tiny amounts of the very food they are allergic to.
It's the same approach that is being used successfully in children with peanut
allergies.
Other researchers report that placing drops or tablets
under the tongue may
someday end the need for pesky shots in some people allergic to pollen and dust
mites.
All the treatments are variations of what doctors call immunotherapy -- the
idea that giving small amounts of an allergen to people with pollen or food
allergies helps to build up the immune system so they can tolerate much higher
amounts before having an allergic reaction.
The new treatments were discussed at the annual meeting
of the American Academy of Allergy, Asthma and Immunology.
A Shorter Course of Allergy Shots
Four preseasonal weekly allergy shots may reduce sneezing, wheezing, and
other symptoms in people who are allergic to ragweed, says Harold B. Kaiser, MD,
an allergist at the University of Minnesota.
“The idea is to build up the same immune protection you get from conventional
treatment, which consists of eight, 10, even 20 shots both before and throughout
allergy season,” he tells WebMD.
The new study involved 381 people with ragweed pollen allergies. About
two-thirds received four shots of Pollinex Quattro every week over a four-week
period leading up to ragweed season. The rest got placebo injections on the same
schedule.
Participants who took Pollinex Quattro reported significantly fewer symptoms
and taking significantly less allergy medication during the three peak weeks of
ragweed season than those given placebo, Kaiser says.
There were no serious side effects, but a few patients withdrew from the
study because of redness and swelling near the injection site.
More study is needed, but the hope is that fewer shots will work “as good or
better than conventional therapy, with fewer doctor visits and better
compliance,” Kaiser says.
In a separate study of nearly 900 people with seasonal
grass pollen allergies, those who received four preseasonal shots of Pollinex
Quattro slept more soundly, had less nasal congestion, and generally felt better, compared
with patients given placebo.
A spokesperson for Allergy Therapeutics, which makes
Pollinex Quattro and funded the studies, tells WebMD that the company hopes to
apply for FDA approval
of the product in the next year. They have already applied for approval in the
European Union.
Skin Patch for Milk Allergies
Eight of 13 children with dairy allergies who wore a skin patch for three
months could drink three times as much milk as before without showing signs of
an allergic reaction, reports Christophe Dupont, MD, PhD, of Hopital Saint
Vincent de Paul in Paris.
None of the seven children given a placebo patch showed that much increased
tolerance, he says.
The experimental skin patch, which is coated with cow's milk powder, was
placed on the children's backs every other day. It's called Viaskin and is made
by DBV Technologies, which funded the research.
One child could drink nearly three cups of milk after three months of
treatment, Dupont says. Others built enough immunity to prevent allergic
reactions if they ate foods that contained trace amounts of milk proteins.
Dupont says that a major advantage of the patch over allergy shots is that
you can remove it if someone suffers an allergic reaction.
Wesley Burks, MD, chief of the division of pediatric allergy and immunology
at Duke University Medical Center, tells WebMD that the approach is promising,
but that more studies looking at its safety are needed. Burks was not involved
with the study.
Oral Immunotherapy for Children With Milk Allergies
Other researchers are following 15 children who successfully completed a
course of oral immunotherapy in which they built up tolerance by swallowing tiny
but escalating doses of milk protein in the form of powder mixed with water.
Four months after stopping treatment, five of the 15 continue to drink at
least two 8-ounce glasses of milk a day, says Satya Narisety, MD, of Johns
Hopkins School of Medicine.
The other children are tolerating an ounce of milk a day on average, he says.
“Even after stopping therapy, they're still able to have milk in their diet,”
he tells WebMD.
The catch: Many still have minor signs of allergic reaction, such as itching on the lip or
tongue or mild stomach aches, about once a week or every other
week.
“The reactions are largely unpredictable, although they are going down in
frequency,” Narisety says.
Under-the-Tongue Approach
Other researchers are studying sublingual immunotherapy, or SLIT, which
involves placing drops or tablets that contain small amounts of an allergen
under the tongue. Several studies presented at the meeting suggest the approach
is safe and may alleviate symptoms in people with pollen and dust mite
allergies.
But not all the news is good: Still other doctors found that SLIT may not
work that well for people who are allergic to more than one type of pollen --
ragweed and grass, for example.
“When we gave drops that contain [grass allergen] alone, outcomes were
significantly improved. But patients given [grass] mixed with nine other
extracts didn't do significantly better than those given placebo,” says Harold
Nelson, MD, of National Jewish Health in Denver.
The big advantage of drops over shots is that you can apply them yourself, at
home, Nelson tells WebMD. But “there's probably a probably a limited role for
single-extract [drops] in the U.S., as most Americans are allergic to multiple
allergens,” he says.
SOURCES:
American Academy of Asthma and Immunology Annual Meeting, Washington D.C.,
March 13-17, 2009.
Harold B. Kaiser, MD, clinical professor of medicine, University of
Minnesota, Minneapolis.
Christophe Dupont, MD, PhD, Hopital Saint Vincent de Paul, Paris.
Wesley Burks, MD, chief, division of pediatric allergy and immunology, Duke
University Medical Center, Durham, N.C.
Satya Narisety, MD, fellow, division of pediatric allergy and immunology,
Johns Hopkins School of Medicine, Baltimore.
Harold Nelson, MD, professor of medicine, National Jewish Health, Denver.
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2009 WebMD, LLC. All rights reserved.
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