Friday, October 15, 2010

Another trip to Duke by way of the beach!

It's been over 3 months since we've last been to the Duke Clinical Research Unit for the peanut SLIT trial.  In fact, our last visit was the food challenge when Abigail consumed up to 8 to 10 peanuts.  Since then it's been status quo.  She continues to consume nothing with peanuts, nothing made using the same equipment or nothing even manufactured in the same facility with other peanut products.  She still takes 8 drops once a day under her tongue, holds them there for 2 minutes and eats nothing before or after for the specified time period.

This visit was short and served only as a "check in" to answer questions and get more drops.  Our next visit, 3 months from now, will be a little more involved.  There will be another blood draw, skin prick test and saliva collection.  This routine will continue until May of 2012.  Every 6 months, testing, 3 months in between, a "check in", maybe even by phone to save us a 2 1/2 hour drive.

I did hear a few updates at this visit.  Our doctor and staff have written a paper with the findings to date.  It's in edit now and should be published by the end of the year.  It's pretty exciting that we've been in the study for long enough that initial results are ready to be made public.  Also, that we are part of those results.

There is also not going to be a food challenge at the 2 year mark as originally planned.  The protocol indicated that a challenge to up to 15 peanuts would be given.  I think they've determined that the food challenge process does not warrant knowing if a child can consume 5 to 7 more peanuts.  If some of the participants in the study can eat 8 to 10 peanuts then they've proven that you can be "desensitized".  Staying on the drops for 3 years is a means to become "tolerant".  Abigail will be food challenged again at that 3 year mark.

I've mentioned in a prior post that the immune system is slow to change, and in the case of food allergies, can take 3 years or more of daily dosing to build up tolerance.  The peanut flour trial has been going strong for over 3 years.  Participants are now eating peanuts on a daily basis, but what happens when they stop eating peanuts.  Will their body remain tolerant?  That question is still unanswered.  Some of those participants stopped for as long as 3 months and were able to then pass the food challenge again.  But Duke has not had them remove peanuts from their diet for any longer than that?  I definitely didn't sign us up for that study!

We incorporated a long weekend at the beach in with this visit.  It was much needed and well deserved.  We finally got our house officially on the market, but it's been an exhausting process.  A trip to the beach was just what we needed.  The weather was fabulous, and we did nothing but play and rest.  There were tidal pools out in front of the house every day that the kids loved swimming in (yes, swimming in October).  Abigail was a real pro at building sand castles as seen in the picture.  So, another trip to Duke, but only after a great weekend at the beach!