SINGAPORE: For most people, eating out is a matter of convenience. But for 18-year-old Kaylene Choe, eating out is troublesome – possibly life-threatening.
“When I go out with my friends, I have to speak to the chefs or the people in the kitchen to make sure there’s no cross-contamination. If (the food) touches anything I can’t eat, then I get an (allergic reaction) so I have to be really careful,” she said.
The teenager is allergic to common food ingredients such as peanuts and eggs. Her allergies have affected her quality of life, and she has to think twice when eating packaged food or accepting food from friends.
But a new egg allergy trial could provide hope for people like Ms Choe.
In a media briefing on Friday (Nov 22), the National University Hospital (NUH) announced that it would be conducting a Probiotic and Egg Allergen Immunotherapy (PEAT) study, which aims to help people with an egg allergy consume eggs without having to worry about an allergic reaction.
Conducted by Dr Lydia Wong, principal investigator, and Dr Elizabeth Tham, of NUH’s division of Paediatric Allergy, Immunology and Rheumatology, the study was inspired by a similar one conducted more than five years ago by the Murdoch Children’s Research Institute (MCRI) in Melbourne that looked into probiotic and peanut immunotherapy treatment.
Trials conducted as part of the Australian institute’s study showed “long-lasting” protection against peanut allergy up to four years post-treatment, said Dr Wong, adding that it makes the PEAT study “promising”.
According to Dr Wong, egg allergy is the most common food allergy for children under three in Singapore, and one of the top three causes of food-triggered severe allergic reactions in adults. Severe allergic reactions include choking, swelling of the airways and low blood pressure.
While many children eventually outgrow their allergies, overseas studies found a significant number of people remain allergic to egg even into adolescence – up to 42 per cent.
The only way of dealing with allergies is to avoid the food and to seek treatment immediately once consumed, said Dr Wong.
This is particularly difficult in the case of egg allergy, as egg is a common ingredient in many types of food.
“This can significantly impair the quality of life for those with egg allergy and their family because total avoidance is close to impossible,” she explained.
A nurse conducts a skin prick test on a patient. (Photo: Cindy Co).
TREATMENT
The PEAT study proposes to increase an allergic individual’s tolerance to egg through a daily dose of a probiotic together with egg oral immunotherapy.
“Food allergies are actually an immune system problem … Food allergy occurs because the immune system recognises something that is innocuous or something that is not harmful like food protein and creates a reaction against it,” said Dr Wong.
Immunotherapy seeks to “modify or change the immune system’s response to this food protein”, she added.
While oral immunotherapy in itself has been shown to be effective, its effect is only temporary. Dr Wong and Dr Tham hope to add in probiotics, which modifies the immune system, to create a life-long protection against egg allergy.
The study will be conducted over 20 months – 18 of which will be used for treatment. There will be a total of 40 patients aged five to 30, and they will be split into two groups – an active group, which will receive the therapy, and a placebo group.
The PEAT trial will be the first of its kind in the world to use both probiotics and oral immunotherapy to protect patients against egg allergy.
Similar trials will be conducted at both research centres – the MCRI and NUH – with the Australian institute as the lead site.
“If we can show that the probiotic food immunotherapy approach is effective in treating egg allergies as well, this will mean that we could perhaps extend this treatment to other food allergies,” Professor Mimi Tang from MCRI said.
“I think it’s great that they’re doing this … if this works out, then it’s going to help a lot of people,” Ms Choe said.
