Artificial intelligence has come a long way. It can do everything from cheering you up with playful flirting to making your emails sound more professional, acting as your personal fashion stylist.
And now even helping you uncover hidden allergies. A viral post on X (formerly Twitter) highlighted the same when a man shared how he used AI to help figure out his girlfriend’s mysterious allergy.
Now, let us ask you what’s the best part of a tropical vacation? The seafood, of course! But for 19-year-old Rhea Sharma (name changed), dishes like butter garlic prawns or lobster rolls have always been off-limits. She was just 10 when she tried prawns for the first time, only to break out in red, itchy rashes that signalled a severe allergic reaction.
Similarly, Nitin Aggarwal (name changed), 33, faces his own culinary challenges, as mushrooms are his trigger. A flare-up of painful rashes on the back of his hands is the telltale sign that mushrooms were sneakily included in his meal.
Food allergies affect millions, and while avoiding known triggers can help, it’s often impossible to detect hidden ingredients. However, there’s new hope on the horizon. Did you know an asthma medication might hold the key to curing food allergies? It’s called Xolair. Interestingly, in February 2024, the US Food and Drug Administration approved this medication as a treatment option to help reduce the risk of severe allergic reactions.
First, know a little about food allergies
Food allergies occur when the immune system mistakenly identifies a harmless food protein as a threat and triggers an immune response.
“This reaction releases chemicals like histamine, leading to symptoms that can vary from mild to severe. Common food allergens include peanuts, shellfish, milk, eggs, and wheat,” Dr Balakrishna GK, HOD and senior consultant, internal medicine, Gleneagles BGS Hospital, Bengaluru, tells India Today.
Adding to this, Dr Tushar Tayal, consultant, internal medicine, CK Birla Hospital, Gurugram, mentions that IgE (immunoglobulin E) is the most common cause of food allergies.
“When a person with IgE antibodies eats the same food allergen again, the allergen binds to the IgE antibodies, causing certain immune cells to release chemicals such as histamine from mast cells. In severe cases, a reaction may occur if the allergen is inhaled or touched, even without eating,” he shares.
Further, Dr Ritu Malani, consultant, allergy and asthma, Max Hospital, New Delhi, explains that the immune response triggered by food allergies can manifest in a variety of ways.
Common symptoms include itching and hives on the skin (acute urticaria), swelling of the lips, eyes, face, or tongue (angioedema), and even swelling in the throat, which can cause a choking sensation.
Food allergies can also lead to respiratory symptoms such as coughing, breathlessness, wheezing, and stridor, along with cardiac issues like palpitations, a drop in blood pressure, and fainting (syncope). Gastrointestinal reactions, including vomiting, stomach cramps, and diarrhoea, are also possible.
“When extreme reactions happen, they are called anaphylactic reactions. These can be life-threatening, and the patient needs immediate emergency care in the form of an adrenaline injection, intravenous steroids, intravenous antihistamines, oxygen, and bronchodilators,” says Dr Malani.
A miracle cure?
Dr Tayal explains that Xolair, a monoclonal antibody targeting IgE (the immune protein involved in allergic reactions), was initially developed to treat conditions like asthma and chronic spontaneous urticaria. Earlier this year, it became the first FDA-approved medication for reducing the risk of allergic reactions to multiple foods in people with food allergies.
“While it’s not a cure for food allergies, it helps reduce the severity of reactions following accidental exposure to allergens,” says Dr Tayal, adding, “In clinical trials, Xolair has demonstrated some efficacy in reducing reactions to allergens like peanuts, cashews, and eggs. However, it’s not a universal solution, and a small percentage of people may not respond well to the treatment.”
Dr Malani agrees, “Xolair does not cure or treat food allergies. It reduces the risk of harmful allergic reactions among certain patients with IgE-mediated food allergies. While it won’t eliminate or allow patients to consume food allergens freely, its repeated use will help reduce the health impact if accidental exposure occurs.”
Meanwhile, Xolair comes with potential side-effects, including fever, dizziness, fatigue, rash, joint pains, and upper respiratory symptoms like rhinitis or sinusitis. In rare instances, more severe side-effects like anaphylaxis may occur.
Xolair in India
According to Dr Balakrishna GK, Xolair is primarily used for asthma and chronic hives in India. Its high cost and limited availability make it less accessible to a broader population.
Dr Malani also shares that, as of now, Xolair isn’t being widely prescribed by allergists in India for food allergies.
Additionally, this medication is highly priced (Rs 28,000 for a 150 mg injection), but biosimilars from other pharmaceutical companies, like Emzumab and Omalirel, have been approved in India, costing approximately Rs 8,000 to Rs 9,000 per 150 mg injection.
Given that the dosing of the injections ranges from 75 mg to 450/600 mg every 2-4 weeks depending on the disease, patient weight, and IgE levels, the cost is a concern for certain sections of the Indian population.
Alternative treatments for food allergies
If you know you have a food allergy, the best course of action is to avoid the allergen altogether. Always take the extra step to check ingredients before eating anything, and inform those around you about your allergy so they can help keep you safe.
When dining out, be sure to alert the chef or server about your allergy to ensure no hidden allergens accidentally make their way into your meal.
Oral immunotherapy (OIT), which involves gradually exposing the patient to increasing amounts of the allergen to build tolerance, is another alternative treatment. It shows promise in desensitising the body over time.
Using antihistamines or carrying an epinephrine auto-injector for emergencies is also an essential part of managing food allergies.