SIO401: Dr. Steve Proper on the Science of Food Allergies
Nov 17, 2023
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Dr. Steve Proper, an actual expert in the field of food allergies, teaches about medical science behind allergies. Discusses recent study that changed understanding of how food allergies are caused. Covers importance of expertise, history of epipens, experiences of parenting with food allergies, differences between asthma and allergic reactions, importance of early introduction of allergenic foods, impact of exposure on food allergies, oral immunotherapy as a treatment, and differences in practicing medicine as an allergist in Cincinnati vs Western Michigan.
Oral immunotherapy (OIT) is a successful treatment for food allergies, gradually increasing allergen intake to build tolerance.
Alternative approaches to OIT, such as the egg ladder and egg oral immunotherapy, are being explored for specific food allergies.
The gut and skin play distinct roles in food allergies, with the skin being sensitizing and the gut being tolerizing.
Deep dives
Oral Immunotherapy for Food Allergies
Oral immunotherapy (OIT) is a treatment for food allergies that involves gradually increasing the intake of the allergen over time, similar to allergy shots. OIT has been particularly successful in treating peanut allergies, with one FDA-approved product called Palforzia. It is taken as a daily pill, and the dosage is gradually increased until a maintenance dose is reached, which is equivalent to consuming about six to seven peanuts a day. OIT helps build tolerance to the allergen, reducing the risk of severe reaction when accidentally exposed to small amounts of the allergen.
The Benefits and Risks of Oral Immunotherapy
OIT has shown numerous benefits, such as providing peace of mind to parents and individuals with food allergies. Being able to tolerate accidental exposure to small amounts of the allergenic food reduces stress and improves quality of life. However, it is essential to acknowledge the risks associated with OIT, including the possibility of mild to severe allergic reactions during the process, especially during the dose escalation phases. Close monitoring and attentiveness to detail are crucial to ensure safety during the treatment.
Other Approaches and Challenges in Managing Food Allergies
In addition to OIT, other approaches like the egg ladder and egg oral immunotherapy are being explored for treating specific food allergies. The egg ladder involves gradually introducing different forms of baked egg products to build tolerance. Meanwhile, egg oral immunotherapy skips the baked forms and directly introduces the raw egg protein, accelerating the tolerance-building process. However, more research is needed to determine the most effective and safe methods for these treatments. It is vital to consult with allergists who specialize in these approaches and carefully consider the benefits and risks before making treatment decisions.
The Role of the Gut and Skin in Food Allergies
The podcast episode discusses how the gut and skin play different roles in food allergies. The skin is a sensitizing surface, while the gut is a tolerizing surface. The skin is designed to keep things out, and when allergens penetrate the skin, it can trigger allergic responses. On the other hand, the gut needs to tolerate friendly bacteria and other substances to aid digestion. The Leap study highlights that repeated exposure through the gut helps individuals develop tolerance to allergenic foods.
The Relationship Between Eczema, Food Allergies, and Tolerance
The episode explores the link between eczema, food allergies, and tolerance. It reveals that eczema can cause food allergies rather than the other way around. Individuals with eczema may experience flares when they eat certain foods, leading to a misconception that the food is causing the eczema. However, the eczema itself activates cells that react to the food protein, resulting in a flare. It is emphasized that controlling eczema is crucial in making progress with food allergies, and early introduction of allergenic foods is recommended to prevent allergies from developing in the first place.
You may have heard our episode about our struggles with food labeling and Arlo's allergies. Well, so did Dr. Steve Proper, and he is an actual expert in the field! He teaches us about the medical science involved. What are allergies? What aren't they? How are they different from other seemingly similar phenomena? But even more interestingly, a somewhat recent study completely changed our understanding of how food allergies are caused! Dr. Steve takes us through it. Are you an expert in something and want to be on the show? Apply here! Please please pretty please support the show on patreon! You get ad free episodes, early episodes, and other bonus content!
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