Edwin Kim, MD MS, director of the UNC Food Allergy Initiative at the UNC School of Medicine, will lead the first study of sublingual immunotherapy to address the feasibility and safety of treating multiple tree nut allergens simultaneously in children.
About 8% of children in the United States have a food allergy, with tree nut allergies among the most common and severe. An experimental treatment called sublingual immunotherapy (SLIT)—where a tiny bit of food protein in liquid form is placed under the tongue and absorbed by the immune system—has been pioneered at the UNC School of Medicine and shown for peanut allergy to fully desensitize the majority of children under 4 years old allowing them to eat up to 15 peanuts without allergic symptoms. For nearly half of the children, this protection remained even after stopping the treatment for 3 months showing a lasting immune effect from the treatment. Researchers say that although results are extremely promising for children allergic to peanuts – a legume grown from seeds planted in the ground — treatment options for tree nut allergy lag behind.
To address this unmet need, Edwin Kim, MD, MS, division chief of Pediatric Allergy and Immunology and director of the UNC Food Allergy Initiative at the UNC School of Medicine, was awarded a $1-million grant by the Food Allergy Research and Education, Inc (FARE) to investigate tree nut allergies in children ages 1-11 years old. Kim will serve as the principal investigator of the three-year research study entitled, “Assessing the potential for cross-reactive desensitization and remission with tree-nut sublingual immunotherapy.”
It is estimated that 50% of children with tree nut allergy are allergic to multiple tree nuts, and those with more allergies are less likely to outgrow them. Trying to treat multiple allergies at the same time increases the difficulty and likely the risk of treatment. The safety seen with SLIT for peanut allergy, commonly recognized as one of the most severe allergies, makes it ideal for multiple tree nut allergy therapy, Kim said. Researchers hypothesize tree nut SLIT will be both safe and effective at desensitizing against single and multiple tree nut allergies. With recent data suggesting rates of cashew allergy to be comparable to peanut allergy, the study will focus on participants who have cashew allergy alone or in combination with walnut allergy. Based on research also showing a strong cross-reactivity between cashew and pistachio allergies and also walnut and pecan allergies, the study will also investigate if SLIT with cashew and walnut would be effective at desensitizing against pistachio and pecan respectively.
This will be the first study addressing the feasibility and safety of treating multiple food allergens simultaneously with SLIT. Additionally, this will be the first study of cashew and walnut SLIT and the first study of the cross-desensitization potential with tree nut SLIT. Kim believes that showing efficacy to foods beyond peanut, and to multiple foods simultaneously, combined with the simplicity and safety of SLIT, could show that SLIT has high potential to be translated into widespread clinical practice.
