Yes, this week I'm going to talk about food allergies again. There's a lot of misinformation out there about the recent 'rise' in the number of children with severe food allergies, and parents are understandably concerned about their kids developing food allergies.
In talking to some of my non-food allergy friend Moms, I've realized that some recent studies that actually provide hope to FA sufferers may be dangerous. Multiple people have asked me if I'm going to try to tolerize the Spawn to peanuts. My answer, of course, is 'sure, when the protocol is approved for clinical use'. Although I give most FA-parents credit for being overly cautious and 'not trying this at home', relatives or caregivers may not be so cautious. Although I could ground a peanut up and dilute it 1:1000 or 1:10,000 per weight in flour, there's no way that I would even consider doing this without the type of balance that I used in lab. My kitchen scale just ain't gonna cut it.
Equally dangerous is the study that came out of Israel last year showing that when examining 'genetically similar' populations in Israel and England, there was a much higher prevalence of peanut allergy in England (recommendation: wait) vs Israel (recommendation: eat a lot of peanuts as soon as you can). The jury's definitely out on if the TIME you introduce a food influences allergy development (I tend to be in the 'It Doesn't' camp but the data's inconclusive at best). Why is this study dangerous? Because FA-reactionaries ('you're just a paranoid Mom') use it to justify their beliefs that parents are causing the damage to their kids.
All I know is that from my personal experience (n=1), withholding and preventing tolerance wasn't the problem. The Spawn broke out in hives after I had a peanut butter sandwich while I was nursing him. (Speaking of which, I've never actually seen any convincing evidence that nursing DOES prevent food allergy - who came up with that one?) His face became red and swollen after his FIRST milk formula bottle (primed by the cowsmilk antigen in the breastmilk). He developed his allergies before I even had a chance to withhold/tolerize. I feel confident that I, at least, didn't do this to him by being a 'paranoid mom' (although I played a large role due to my genetic contribution).
So what's the conclusion of my rant? Although these studies are good news for allergy sufferers, they certainly aren't a cure. By letting the general public feel more relaxed about the dangers of food allergies, the news hype surrounding the stories may actually do more harm than good.
Product recommendation: I have recently discovered Amy's organic soup (and other Amy's organic products). The Spawn can't eat milk or soy, and ricemilk isn't nearly as fatty (necessary for baby brain growth). Amy's has both normal (high fat and good for the Spawn) and fat-free (good for me) versions of nutritious soups that are high in protein and vitamins and minerals. The Spawn LOVES them (will even eat the dreaded GREEN BEAN in the context of Amy's vegetable soup). If you're looking for an easy, healthy, allergy friendly meal, this is the way to go (they should sponsor my blog).
Wednesday, March 25, 2009
Wednesday, March 18, 2009
For all of my allergic-panicked parent brethren, check out this Yahoo news article on hope for peanut allergy sufferers.
http://news.yahoo.com/s/ap/20090315/ap_on_he_me/med_peanut_allergy
I have the (likely false) egomania that because I'm a scientist, an IMMUNOLOGIST, I should be able to cure the Spawn's food allergies. The problem, of course, is that I've done my work primarily in mice, and mice don't get food allergies (at least they don't on rodent diet). To model food allergy in mice, you have to inject them with an allergen, along with some sort of stimulating adjuvant (I wonder if it works like this in humans too and we don't know it). Of course, the human population is a lot more genetically variable than inbred strains of mice, so we'd be much more likely to see variability in the extremes of immune system function, but my opinions on the limitations of using inbred mouse models of human disease deserves its own series of posts.
The concept of tolerization has been around for a long time. This is the basis for "allergy vaccines". You provide your immune system with small, but increasingly larger, doses of allergen until it recognizes the allergen as non-threatening (to simplify to the point where even the Spawn would understand what I'm saying) and shuts off the immune response. This is commonly used for certain environmental allergens, but has been avoided for food allergens due to 1) their potential severity 2) their inpredictability and most importantly 3) the fact that it doesn't work. The mucosal/oral/intestinal immune response is distinctly different from other types of immune response, and much more poorly studied. Only recently has mucosal immunity even received it's own subgrouping at major immunology conferences. Therefore, it's no surprise that food allergen tolerization has been a failure - we don't understand enough about the underlying biology to tolerize properly.
Enter the new clinical study out of NC and Arkansas. They slow induce tolerance with incredibly small (<1/1000 peanut) but increasing oral doses of peanut flour until kids can eat the equivalent of 15 peanuts without a reaction (hard to imagine accidentally eating 15 peanuts). The real kicker with this study is that once the therapy is stopped, some of the kids were still tolerant 2 years down the line. Me, I'd rather take a daily peanut flour dose than risk a surprise anaphylactic reaction with no epipen, but I guess I'm just conservative. This therapy could enter clinical practice in 2-3 years (just when the Spawn is old enough to give it a try).
Anyway, the study is well done and gives me hope that the Spawn won't have to be a bubble boy, never going on adventurous vacations b/c of the lack of nearby hospital and having an embarrassing Mom always explain the use of the epipen to prevent "Dead Kid" to friends' parents and teachers. The counter-culture attack on allergy-kids ("it's just crazy over-protective parents, there's nothing wrong with the kids") will make managing dangerous food allergies even more difficult, and so I hope this tolerization therapy actually takes.
http://news.yahoo.com/s/ap/20090315/ap_on_he_me/med_peanut_allergy
I have the (likely false) egomania that because I'm a scientist, an IMMUNOLOGIST, I should be able to cure the Spawn's food allergies. The problem, of course, is that I've done my work primarily in mice, and mice don't get food allergies (at least they don't on rodent diet). To model food allergy in mice, you have to inject them with an allergen, along with some sort of stimulating adjuvant (I wonder if it works like this in humans too and we don't know it). Of course, the human population is a lot more genetically variable than inbred strains of mice, so we'd be much more likely to see variability in the extremes of immune system function, but my opinions on the limitations of using inbred mouse models of human disease deserves its own series of posts.
The concept of tolerization has been around for a long time. This is the basis for "allergy vaccines". You provide your immune system with small, but increasingly larger, doses of allergen until it recognizes the allergen as non-threatening (to simplify to the point where even the Spawn would understand what I'm saying) and shuts off the immune response. This is commonly used for certain environmental allergens, but has been avoided for food allergens due to 1) their potential severity 2) their inpredictability and most importantly 3) the fact that it doesn't work. The mucosal/oral/intestinal immune response is distinctly different from other types of immune response, and much more poorly studied. Only recently has mucosal immunity even received it's own subgrouping at major immunology conferences. Therefore, it's no surprise that food allergen tolerization has been a failure - we don't understand enough about the underlying biology to tolerize properly.
Enter the new clinical study out of NC and Arkansas. They slow induce tolerance with incredibly small (<1/1000 peanut) but increasing oral doses of peanut flour until kids can eat the equivalent of 15 peanuts without a reaction (hard to imagine accidentally eating 15 peanuts). The real kicker with this study is that once the therapy is stopped, some of the kids were still tolerant 2 years down the line. Me, I'd rather take a daily peanut flour dose than risk a surprise anaphylactic reaction with no epipen, but I guess I'm just conservative. This therapy could enter clinical practice in 2-3 years (just when the Spawn is old enough to give it a try).
Anyway, the study is well done and gives me hope that the Spawn won't have to be a bubble boy, never going on adventurous vacations b/c of the lack of nearby hospital and having an embarrassing Mom always explain the use of the epipen to prevent "Dead Kid" to friends' parents and teachers. The counter-culture attack on allergy-kids ("it's just crazy over-protective parents, there's nothing wrong with the kids") will make managing dangerous food allergies even more difficult, and so I hope this tolerization therapy actually takes.
Wednesday, March 4, 2009
The Value of Complaining
I just read an article in the Wall Street Journal that waxes eloquent about one of the key "benefits" of the recession/depression, an increase in gratitude and a decrease in complaining. http://online.wsj.com/article/SB123612215614023427.html
While I agree that individuals may be more content if they are grateful for what they have and don't complain about what they lack, I would strongly disagree that a decrease in complaining is a positive change for American society. Gratitude and contentment are dangerous things. Discontent breeds innovation, entrepreneurialism, and change. Someone who's grateful they have their job takes less risks. They're much less likely to pursue their dream, experience new things, or even hold people to account for subpar behavior.
On example in the article is Mr. Hirsch, a director at Credit Suisse. While I'm sure Mr. Hirsch is quite happy that his clients are content with a 35% loss in their investments, as a fund manager he should be expected to outperform the market - value companies based on actual, not perceived, value (anyone else notice the falling P/E ratios?). His clients SHOULD complain.
The United States has been successful because it's population is traditionally not content. Immigrants, whether us or our great-great(etc)-grandparents, who form the backbone of this nation, are inherently not content with their 'lot in life'. We landed on the moon because we 'wanted more'. Be glad that Jenner or Pasteur wasn't content or grateful. I've heard rumor that MLK was a complainer.
In these troubled times, we NEED people to complain. Fearful acceptance got us into the Iraq war. Complacence led to the collapse of the credit markets. Things do not always work out for the best, and the ostrich-head-in-the-sand strategy can only make things worse. So I'm going to do my civic duty - I'm going to continue to bitch and complain.
While I agree that individuals may be more content if they are grateful for what they have and don't complain about what they lack, I would strongly disagree that a decrease in complaining is a positive change for American society. Gratitude and contentment are dangerous things. Discontent breeds innovation, entrepreneurialism, and change. Someone who's grateful they have their job takes less risks. They're much less likely to pursue their dream, experience new things, or even hold people to account for subpar behavior.
On example in the article is Mr. Hirsch, a director at Credit Suisse. While I'm sure Mr. Hirsch is quite happy that his clients are content with a 35% loss in their investments, as a fund manager he should be expected to outperform the market - value companies based on actual, not perceived, value (anyone else notice the falling P/E ratios?). His clients SHOULD complain.
The United States has been successful because it's population is traditionally not content. Immigrants, whether us or our great-great(etc)-grandparents, who form the backbone of this nation, are inherently not content with their 'lot in life'. We landed on the moon because we 'wanted more'. Be glad that Jenner or Pasteur wasn't content or grateful. I've heard rumor that MLK was a complainer.
In these troubled times, we NEED people to complain. Fearful acceptance got us into the Iraq war. Complacence led to the collapse of the credit markets. Things do not always work out for the best, and the ostrich-head-in-the-sand strategy can only make things worse. So I'm going to do my civic duty - I'm going to continue to bitch and complain.
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