Fecal microbial therapy in patients with peanut allergy has good early effect

Peanut allergies are difficult to treat and can lead to fatal or near-fatal allergic reactions

Rima Rachid, MD, Principal Investigator and Co-Director of the Boston Children's Food Allergy Program, will present a morning symposium on food allergies at the annual meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI) on February 26 published this result

FMT therapy is derived from fecal samples provided by healthy, allergy-free donors and delivered in frozen capsules

"These results are very encouraging," Rashid said

Why use FMT to treat food allergies?

A growing body of evidence supports the idea that the bacteria that live in our gut help shape our immune system

The Phase 1 open-label trial enrolled 15 participants, ages 18 to 33, who had an allergic reaction to 100 mg (half a peanut) or less

In the second group, five participants were pretreated with antibiotics as an additional measure to kill their own microbiomes and clear the way for donated bacteria

FMT has no serious adverse reactions

"This suggests that the therapeutic response to FMT is related to the microbiota," Rachid said

A new treatment option?

Currently, food allergies are usually treated by gradually increasing peanut intake under the supervision of a doctor, sometimes with drugs that suppress the immune response

"The long-term effects of oral immunotherapy are unknown, and many patients discontinue treatment over time," she said

The trial was conducted on a multi-year basis

The researchers then performed FMT experiments in mice, transplanting the babies' fecal bacteria into allergy-prone mice

Rachid now hopes to conduct a Phase 2 clinical trial in children ages 12-17, in collaboration with Alexander Khoruts, MD, of the University of Minnesota, to provide antibiotic-pretreated and purified microbial transplantation therapy (MTT) formulations

"Home management makes microbiome interventions very attractive," Rachid said

Talal Chatila, MD, is a co-senior investigator for the study