How to treat food allergy desensitization

To put it simply, the core logic of food allergy desensitization treatment is to allow people who are originally allergic to a certain food to be exposed to the allergenic food from a very small dose that will not cause discomfort at all, and slowly increase the dose. After long-term persistence, the immune system will gradually become "familiar" with this substance, so that the next time it encounters it, it will not release excessive allergy mediators and cause discomfort.

When I was doing follow-up visits in the allergology department two years ago, I met a 7-year-old boy with a peanut allergy. He had gone into shock after eating bread with broken peanuts and was sent to the emergency room. Even when he went to the park and encountered peanut shells dropped by others, he had to walk around. When he was first desensitized, the doctor gave him a starting dose of peanut protein solution diluted to a concentration of several hundred thousandths. He put two drops under the tongue every day. After taking it for three weeks without any rash or coughing reaction, he dared to increase the dosage to less than one milligram. After 14 months, he can now eat five roasted peanuts without any reaction, and he no longer has to ask in advance if there are any peanut products at class reunions.

However, not everyone recommends desensitization. There is actually quite a lot of disagreement in the academic community about this. Some clinicians believe that most of the current desensitization treatments are not lifelong effective. Many people insist on eating normally for two or three years. After stopping for more than half a year, the tolerance will fall back and even return to the previous allergy state. Moreover, the dosage needs to be adjusted repeatedly throughout the process. If the family does not control the amount when eating, the risk of triggering laryngeal edema and anaphylactic shock is very high, especially for allergic people with severe asthma. Many tertiary hospitals will not accept the desensitization needs of such people. What's more, there are only standardized dosage references for desensitization to common allergens such as milk, eggs, and peanuts. If you are allergic to niche allergens such as mango, peach, or even celery, there is no mature plan to refer to, and it is extremely cost-effective.

I met a 28-year-old girl who was allergic to eggs before. She didn't have any problems if she didn't eat eggs. After seeing other people's desensitization success, she was so excited that she found a private institution to do it. However, when she increased the dosage to a quarter of egg whites, she suddenly developed wheezes all over her body and she couldn't breathe. Fortunately, she was downstairs in the institution and was sent to the emergency room for treatment. After that, she never dared to mention the desensitization, saying that it would be easier to pay more attention to her meals.

Nowadays, the mainstream food desensitization methods are basically in the form of sublingual or oral administration, and there are very few injections. After all, the probability of severe allergies caused by injected allergens is too high, and it has long been eliminated by most hospitals. The whole process is also very demanding. It is best to stay in the hospital for half an hour on the day of each dose increase, and then leave if there is no reaction. You also need to always have an epinephrine pen at home, so that if there is an emergency, you can save yourself as soon as possible.

A while ago, I saw a new study saying that supplementing specific probiotic strains while desensitizing can speed up the establishment of tolerance. However, it is still in the third phase of clinical trials and has not been widely rolled out. If you have the idea of ​​desensitization, it is best to go to the allergy department of a regular hospital for a comprehensive allergy assessment to see the severity of the allergy and whether there is a mature desensitization plan for the allergen, and then decide whether to do it. But do not try it at a small dose at home. It is really too risky.