How close are we to a ‘cure’ for food allergies?
Food allergies have “become a global problem”
Dr Tina Sindher is Clinical Assistant Professor of Allergy and Immunology in the Department of Medicine, Division of Pulmonary and Critical Care Medicine for the pioneering Sean N. Parker Center for Allergy and Asthma Research at Stanford University
Can you prevent your child from developing a food allergy? How close are we to a ‘cure’ for allergies? And is our super-clean pandemic lifestyle causing problems for our children’s microbiomes that could make them more likely to develop allergies?
I’d been eager to know these since lining up my interview with Dr Tina Sindher.
As Clinical Assistant Professor of Allergy and Immunology in the Department of Medicine, Division of Pulmonary and Critical Care Medicine for the pioneering Sean N. Parker Center for Allergy and Asthma Research at Stanford University here in Silicon Valley - Dr Tina is at the forefront of ground-breaking allergy research and clinical trials.
“Having a dog is productive at a young age”
The center is working hard on prevention research, new treatments, and even a lasting cure for allergies and asthma.
Food allergies have “become a global problem,” she told me in episode 56. “In the past several decades, the prevalence and incidence has just been rising exponentially.”
“The rate of food allergy and eczema started skyrocketing around the time when washing machines and detergents became widespread”
The rate among children is reportedly 8%, and in adults “the rate of self reported is as high as 10%,” she said.
Those allergies can vary from oral allergy syndrome to anaphylactic reactions. The latter is something I have experience of. Carrying auto adrenaline injectors for my nut allergy is normal for me.
The rate of food allergy among children is reportedly 8%
So, what’s behind the shocking rise in food allergies? Dr Sindher told me there are several theories.
“It is multifactorial… It's many things together that just tip the scale for some people.”
She told me about “the six Ds of food allergy” - lifestyle aspects that may affect how allergic we become.
They are: diet, diversity, dogs, dry skin, detergent and vitamin D.
An “increase in processed foods, and maybe lower diversity in foods can also increase food allergies,” she explained.
As for dogs, less exposure to animals can be a risk factor “so having a dog is productive at a young age.”
The dirt factor is also known as the hygiene hypothesis - “we're so clean now that we have fewer exposures to allergens.”
Dry skin; “when you're a baby, and you have very severe dry skin or eczema, we think the barrier is broken and allergens are entering and communicating with your immune response through the skin.”
Detergent appears to be an area of growing research. “They found that the rate of food allergy and eczema started skyrocketing around the time when washing machines and detergents became widespread.
“To make our detergent so good they add in proteases, which break down enzymes. To get that amazing smell, that means the detergent is still present and interacting with our mucosa, interacting with our skin, causing enzyme breakdown and making it easier for allergens to enter and communicate with our immune system in a way that we're not meant to.”
Regarding vitamin D, Dr Sindher said: “We've become more sedentary. We're outside less. We're not exposed in the sun, we're seeing less dirt. So, our lifestyle has tipped us over as well.”
Will working on the six Ds prevent an allergy from developing?
“In terms of what can parents do, I was once told by someone that we if we start adopting what our ancestors did, for instance; having a diverse diet, eating more fermented foods, probiotics, prebiotics, being outside more… It may not prevent, because there's so many factors working towards developing allergies, but it can't hurt. And if it can protect us, then that's even better.”
About getting dirty; I asked Dr Sindher if she had concerns about our super-clean pandemic living and it’s potential for impacting our children’s microbiomes to make them more susceptible to developing food allergies.
“It is something I have been thinking about a lot,” she told me, expressing her concerns that bleach cleaners may not always get wiped off surfaces adequately, which could mean we unknowingly touch or absorb the ingredients.
“I just worry that with this increase in chemical exposures, how that will be affecting our [skin] barrier and our microbiome.”
But on the flip side, she suspects other aspects of pandemic life may be protecting us from allergens.
“I wonder… being home, are they eating better? Are they exposed to their dog more? Are they spending more time outside because they cannot have playdates inside?”
Vitamin D is one of “the six Ds of food allergy”
“A lot of our food allergic children also have asthma, and uncontrolled asthma or an asthma flare actually makes your food allergic reactions worse. And we have seen a notable decrease in asthma exacerbations because kids are home, they're wearing masks. They're just not getting viral triggers that exacerbate their asthma.”
While exciting new avenues for treatments are being explored (watch episode 56 to hear about an allergy vaccine, skin patch and mouth drops), I asked Dr Sindher how close the Sean N. Parker Center for Allergy and Asthma Research is getting to discovering a lasting cure for allergies and asthma.
“We still have a long way to go. But we're also focusing our gaze on prevention instead of treating food allergy after it's developed.”
“It is such a worldwide issue, it affects quality of life and it's not just the person it's their whole family. We see little children that are growing up afraid of social situations, who’ve never been on a plane, who've never been to a carnival because they have severe food allergies. And I think by preventing food allergies, you're taking away trauma from a lot of these children and families, which has long term well-being effects.”
Scientists at the center are also working on developing “precision medicine,” - “where a person can come in and we can check their blood and say, ‘This is the ideal therapy for you’.”
That’s not an option yet - and for anyone new to the allergy path there’s a lot to get your head around, especially if you’re a new parent, but Dr Sindher suggests finding a medical team that stays abreast of the frequently changing guidelines and new research.
Her top tip, though, is to find a support system.
“When the baby's little, they don't know they have a food allergy. They're just living life. It's the family that's affected.”
“This is really daunting. And it is one of those things that unless you are personally affected, it's hard for other people to understand. I think just having connection with people who've been through it, who know what the options are, is huge.”
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