Geller, now 14, has severe food allergies. Until recently, he couldn't safely eat even the tiniest bit of any food containing cashew, pistachio, milk, eggs or fish. His situation is not uncommon: 30 percent of people with food allergies are allergic to more than one food.
"Having food allergies separates you from everyone else," said Joshua's mom, Kristen Geller, when I spoke to her recently. Ordinary childhood and family activities such as birthday parties and restaurant meals were a constant source of anxiety for Joshua and his family.
But lately, the family's worry has lifted: Joshua participated in a clinical trial at the Sean N. Parker Center for Allergy and Asthma Research at Stanford University, where he was successfully desensitized to four of his five allergy-triggering foods.
The trial, published today in The Lancet Gastroenterology and Hepatology, offers hope to other kids in similar situations. The study combined oral immunotherapy -- an approach in which patients are carefully dosed with tiny, gradually increasing amounts of their food allergens -- with omalizumab, a medication that ramps down the allergic response. The new study was a placebo-controlled, blinded Phase 2 trial in 48 children and teens. It built upon a similar Phase 1 study published by the same researchers three years ago.
From our press release:
'We were excited to see the clinical efficacy of this combination approach using omalizumab and multiple foods,' said [lead study author Sharon Chinthrajah, MD]. 'This could be a very promising way to decrease the burden of living with food allergies.'
'The study showed significant efficacy and safety improvements in multi-allergic patients treated with omalizumab and food immunotherapy,' said co-author Kari Nadeau, MD, PhD, director of the Parker Center and professor of pulmonary and critical care medicine and of pediatric allergy and clinical immunology. 'Multi-allergic patients are at much higher risk for anaphylactic reactions since they are allergic to more foods, and omalizumab can help change the course of therapy by making it safer and faster.'
The Geller family is excited, too. Joshua was desensitized to all his food allergens except fish, which is much less likely than nuts, milk or eggs to be hidden in everyday foods. Like other people who have gone through oral immunotherapy, he has to continue eating a bit of the allergy-triggering foods each day to maintain his tolerance to them. Researchers at the Parker Center are conducting further trials to figure out how the immune system changes at a molecular level when tolerance develops.
Josh is trying many new foods that he couldn't eat in the past, according to his mom.
"He's loving everything, and he seems a lot healthier," Kristen said. "Socially, it's a lot better for him, too." Joshua no longer has to explain his food allergies to friends and can eat what everyone else is eating. Meanwhile, Kristen can grocery shop and cook with much less worry. "It's completely changed our lives," she said.
Previously: Silicon Valley entrepreneur Sean Parker establishes allergy center at Stanford; Batman has his utility belt -- and I have my EpiPen and Ask Stanford Med: Pediatric immunologist answers your questions about food allergy research
Photo of Joshua playing tennis courtesy of Kristen Geller