Food allergies are an immune system overreaction to proteins in a wide variety of foods. In fact, more than 50 million Americans are affected by them, some critically, and some moderately [1]. That is a staggering 1 in 10 adults and 1 in 13 children in the United States [7]! Eggs, fish, milk, peanuts, shellfish, soy, tree nuts, and wheat account for 90% of all food allergies, but there are occurrences of allergies for almost every food [1]. Details about some of the extreme cases of allergies can be inferred from personal examples such as the Klein family: 13-year-old Carly Klien is severely allergic to peanuts, tree nuts, sesame seeds, shellfish and many fruits. This extreme sensitivity has limited her quality of life as she constantly has to be minimizing risk, like calling restaurants and stores ahead of time [2]. One day, on an airplane, Carly had an allergic reaction to a sesame seed on her seat. Luckily, she took Benadryl and her cold-like symptoms were reduced. Now she uses disinfecting wipes whenever she boards an airplane. Her mother expresses, “It is challenging to see things her older sister (Katie) can do — the experiences she can have — and know that Carly will never be able to do those because there is too much risk involved [2].” However, what if the millions of realities like Carly's could be changed through medical innovation?
On February 16, 2024, the FDA approved the drug Omalizumab (Xolair) to moderate allergic responses. In a double-blind clinical trial, 168 total subjects who were allergic to peanuts and two other foods were split into control groups and randomly given Xolair or a placebo. 68% of those given Omalizumab were able to consume 2 peanuts (600 mg) without moderate or severe symptoms. Only 6% of those in the placebo group had the same results. These statistics are encouraging, and the drug is highly studied as was originally approved in 2003 for the treatment of asthma [3]. Omalizumab functions as a “sponge and picks up the allergy antibodies” that would normally cause problems in the body [4]. Dr. Kelly Stone of the FDA summarizes the research by saying, “While it will not eliminate food allergies or allow patients to consume food allergens freely, its repeated use will help reduce the health impact if accidental exposure occurs [3].”
Another exciting method to possibly end all food allergies is by utilizing gene editing tools. CRISPR is one example of this and it has received much attention lately as its applications could theoretically be utilized to treat all diseases related to the genome. DNA engineering has the ability to alter human or even plant DNA to knock out culprit allergy genes. For example, researchers have used RNAi technology to zone in on and disrupt the Ara h 2 gene to create nonallergenic peanuts that would reduce allergic reactions in humans [5]. This technology “refers to a phenomenon where small pieces of RNA can shut down protein translation by binding to the messenger RNAs that code for those proteins [9].” The Ara h 2 protein in peanuts is known to bind to specific proteins in those with peanut allergies. One study was able to reduce the Ara h 2 content from 27.73% in wild-type peanuts to 2.87 - 6.24% in altered peanuts using RNAi technology [8]. Much more research is needed in these areas, but the implications are exciting.
Additionally, a survey study in the Journal of American Medical Association estimated the economic cost of childhood food allergies to be around $24.8 billion. The estimate was made by accumulating a sample of 1643 surveys from parents of children with food allergies. The possibility of reducing or neutralizing food allergies before they even begin would save lives and improve quality of life by granting freedom to families like the Klein family. Instances like these represent food allergies are a critical issue that needs to be addressed now [6].
Graphic by Ariha Mehta
Reviewed by Sanjana Anand
References
Food Allergies: Symptoms, Treatments. (2023, September 8). Cleveland Clinic; Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9196-food-allergies
Personal Stories. (n.d.). Mary H. Weiser Food Allergy Center; The University of Michigan. Retrieved October 3, 2024, from https://medicine.umich.edu/dept/foodallergy/outreach-advocacy/personal-stories
FDA Approves First Medication to Help Reduce Allergic Reactions to Multiple Foods After Accidental Exposure | FDA. (n.d.). U.S. Food and Drug Administration; FDA. Retrieved October 3, 2024, from https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-help-reduce-allergic-reactions-multiple-foods-after-accidental
Got Food Allergies? Omalizumab is a Game Changer in Preventing Severe Reactions | URMC Newsroom. (2024, April 26). The University of Rochester Medical Center Newsroom; URMC Newsroom. https://www.urmc.rochester.edu/news/publications/health-matters/got-food-allergies
Wang, M., Schedel, M., & Gelfand, E. W. (2024). Gene editing in allergic diseases: Identification of novel pathways and impact of deleting allergen genes. Journal of Allergy and Clinical Immunology, 1, 51–58. https://doi.org/10.1016/j.jaci.2024.03.016
Gupta R, Holdford D, Bilaver L, Dyer A, Holl JL, Meltzer D. The Economic Impact of Childhood Food Allergy in the United States. JAMA Pediatr. 2013;167(11):1026–1031. doi:10.1001/jamapediatrics.2013.2376
Facts and Statistics - FoodAllergy.org. (n.d.). Food Allergy Research & Education; FARE. Retrieved October 4, 2024, from https://www.foodallergy.org/resources/facts-and-statistics#:~:text=How%20Many%20People%20Have%20Food,more%20than%2027%20million%20adults.
Dodo, H. W., Konan, K. N., Chen, F. C., Egnin, M., & Viquez, O. M. (2007). Alleviating peanut allergy using genetic engineering: the silencing of the immunodominant allergen Ara h 2 leads to its significant reduction and a decrease in peanut allergenicity. Plant Biotechnology Journal, 2, 135–145. https://doi.org/10.1111/j.1467-7652.2007.00292.x
Staff, A. A. S. (2019, September 30). What is RNA Interference? | Ask a Scientist. Ask a Scientist; https://www.facebook.com/thermofisher. https://www.thermofisher.com/blog/ask-a-scientist/what-is-rnai/
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