For years those who suffered from environmental allergies have been experiencing relief through allergy shots, but those living with severe food allergies have typically had little recourse but to avoid items that could trigger an allergic reaction. All that is changing, however, as potentially life-saving relief for the food allergic is now being offered by allergists who are using the same concept to desensitize patients to allergenic foods with an innovative treatment known as Oral ImmunoTherapy (OIT).
Dr. Joel Selter of Allergy and Asthma Care of Rockland is just one of two board-certified allergists in private practice in New York State who have been successfully using OIT to treat patients who are allergic to milk, peanuts, tree nuts, eggs, sesame, soy and wheat. The protocol starts with a six to eight hour office visit where the patient is given a miniscule dose of the allergen and is diligently monitored. Those who tolerate the allergen are given increasingly higher doses of the same substance and are sent home with a solution containing the allergen to be consumed either once or twice a day.
“We are employing the same philosophy we have used for allergy treatment with immunotherapy but with OIT, we are giving the food allergen the way it was meant to be given, orally,” Dr. Selter told The Jewish Link. “By starting with minute dilutions we hope that the body will be tricked into not recognizing the substance in an allergic way.” OIT patients return to Dr. Selter for regular visits at either his Suffern or Monroe office, and receive escalating doses of the allergen at weekly or biweekly visits, with many at maintenance levels within four to six months. While some patients will need to continue their daily maintenance dose in order to maintain desensitization for the long term, others find themselves fully tolerant and able to eat items they were previously allergic to with no limitations. Over time and with additional clinical data, Dr. Selter hopes to establish a more exacting profile of which patients will develop that full tolerance.
Dr. Selter’ s first OIT patient came to him after having successfully undergone the protocol in Texas for an egg allergy, and subsequently began experiencing problems when she stopped taking her maintenance dose. Having considered the idea of incorporating OIT into his practice for some time, Dr. Selter realized that this woman was the perfect candidate. She began and successfully completed the OIT treatment protocol and has now been eating two scrambled eggs for breakfast every day, for over a year.
Dr. Selter estimates that he has had a greater than 90 percent success rate, treating even the most severely allergic patients. Because consistency is a major determinant of successful OIT, it is crucial for patients and their parents to be completely dedicated to the prescribed treatment plan.
“Talking and listening to my patients is key,” said Dr. Selter. “One of the benefits about performing OIT in a private-practice setting is the flexibility to tailor the protocol to the individual.”
Dr. Selter has treated patients as young as 3 years old and has found most insurance companies receptive to this treatment, thereby creating an affordable solution. OIT enables patients restricted by food allergies to avoid potentially devastating reactions to certain foods. While not being restricted to certain foods is extremely convenient, OIT’ s greatest benefit is the safety factor. While there are those who question its safety, Dr. Selter believes that OIT can be as safe, or safer than, avoiding allergenic foods.
“If we can build someone’ s tolerance for a particular allergen, then down the road he or she will be able to freely ingest that food,” said Dr. Selter. “OIT takes away the fear that one is constantly in danger. Children and adults alike should be able to enjoy life with as few limitations as possible. That might include going to a birthday party and not inspecting every ingredient list or eating at a restaurant without interrogating the waiter, the maitre d’ and the chef. And yet, mistakes are still made and anaphylactic reactions still do occur. But by undergoing OIT, the risk of a reaction is markedly decreased.”
“In the past when we had patients with life-threatening food allergies, the advice we gave them was ‘ avoid, avoid, avoid,’”added Dr. Selter. “Now we are telling patients they can enjoy and even indulge.”
Dr. Selter is optimistic that OIT will be a game changer in the world of food allergies.
“I have had patients who are allergic to peanuts who can now enjoy their Snickers or their Bamba worry free, and parents can breathe a sigh of relief,” said Dr. Selter. “This is phenomenally exciting and I am thrilled to be at the forefront of this process. Imagine a world without a peanut-free zone!”
Sandy Eller is a freelance writer who writes for numerous websites, newspapers, magazines and many private clients. She can be contacted at [email protected].
