Can Oral Immunotherapy Trials Offer New Hope for People with Nut and Other Allergies?

For millions of people across the UK and beyond, living with a severe nut allergy means constantly reading labels, carrying an adrenaline auto-injector, and sometimes missing out on shared meals, holidays, or even school trips. 

But a promising area of research, oral immunotherapy (OIT), may be about to change that.

What Is Oral Immunotherapy?

Oral immunotherapy involves giving someone a tiny, controlled doses of an allergen (like peanuts, tree nuts, or milk) in gradually increasing amounts over time. 

The goal is to train the immune system to become less reactive or even tolerant to the substance. It's not a cure, but it could reduce the risk of severe reactions from accidental exposure.

How OIT Trials Work

Participants in OIT trials usually start with a minute dose of the allergen, often a fraction of a milligram, and increase their intake slowly over several months under medical supervision. These trials are carefully monitored and often conducted in hospital settings due to the risk of reactions.

Recent UK-based and international trials, including studies at institutions like Addenbrooke’s Hospital in Cambridge and Imperial College London, have shown that up to 70–80% of participants can build up some level of desensitisation. That means they may not react, or may only have a mild reaction, if they accidentally eat a small amount of the allergen.

Who Might Benefit?

Children with peanut, hazelnut, or other tree nut allergies

People allergic to milk or eggs

Families hoping to reduce daily anxiety around food

Those at high risk of accidental exposure

However, OIT is not suitable for everyone, especially those with a history of severe or uncontrolled asthma or anaphylaxis. It’s important that any decision to begin this type of therapy be made with an allergy specialist.

Are There Risks?

Yes, OIT can cause allergic reactions, especially during the build-up phase. Some people experience gastrointestinal upset, mouth itching, or more serious reactions. That’s why trials are so vital—to determine who benefits most and how to keep them safe.

The Future of Allergy Care?

While OIT is still not widely available on the NHS, several trials are ongoing and commercial treatments (like Palforzia, a peanut allergy treatment approved in the UK) are emerging. With further research, personalised immunotherapy plans could become a mainstream part of allergy care.

Oral immunotherapy isn’t a magic bullet, but it may be a significant step forward in empowering people with food allergies to live more confidently. If you or your child are living with a nut or other food allergy, talk to your GP or allergy specialist about whether an OIT trial might be an option for you.

Cooking with Nut Butters: A Nutty Adventure in the Kitchen

Nut butters are a versatile and delicious addition to any kitchen. Whether you’re a seasoned chef or a novice cook, incorporating nut butters into your recipes can elevate your dishes with rich flavours and creamy textures. 

From the classic peanut butter to the luxurious almond and cashew butters, there’s a whole world of culinary possibilities waiting to be explored.

The Basics of Nut Butters

Nut butters are simply ground nuts transformed into a smooth or a chunky paste. They come in a variety of types, each offering unique tastes and nutritional benefits:

Peanut Butter: A pantry staple, known for its distinct, robust flavour and creamy texture.

Almond Butter: A slightly sweet, delicate alternative to peanut butter, packed with vitamins and minerals.

Cashew Butter: Smooth and buttery, with a subtle sweetness, ideal for both sweet and savoury dishes.

Hazelnut Butter: Often paired with chocolate, it offers a rich, indulgent flavour.

Nut Butter in Savoury Dishes

Nut butters aren't just for spreading on toast or blending into smoothies. They can add depth and creaminess to a variety of savoury dishes:

1. Nutty Satay Sauce:

A classic use of peanut butter in Asian cuisine. Combine peanut butter with soy sauce, lime juice, garlic, and a bit of chilli for a spicy, tangy sauce perfect for grilled chicken or tofu skewers.

2. Creamy Nut Butter Soup:

Add a spoonful of almond or cashew butter to soups like butternut squash or sweet potato for a rich, velvety texture. It’s a great way to add extra protein and healthy fats to your meal.

3. Nut Butter Stir-Fry:

Create a quick and easy sauce with cashew butter, soy sauce, ginger, and garlic. Toss it with your favourite vegetables and protein for a flavourful stir-fry.

Sweet Treats with Nut Butters

Nut butters shine in desserts, providing a creamy base and nutty undertones:

1. Classic Peanut Butter Cookies:

A timeless treat, these cookies are simple to make and incredibly satisfying. Combine peanut butter with sugar, egg, and a touch of vanilla for a deliciously chewy biscuit.

2. Almond Butter Brownies:

Swap out some of the butter in your favourite brownie recipe for almond butter. This adds a subtle nutty flavour and makes the brownies extra moist and decadent.

3. Nut Butter Smoothies:

Blend almond or cashew butter with bananas, a splash of milk, and a drizzle of honey for a creamy, nutritious smoothie that’s perfect for breakfast or a post-workout snack.

Creative Uses for Nut Butters

Think outside the jar and use nut butters in unexpected ways:

1. Salad Dressings:

Whisk together almond butter, lemon juice, olive oil, and a bit of honey for a creamy, tangy salad dressing. It pairs wonderfully with leafy greens and roasted vegetables.

2. Nut Butter Marinades:

Create a flavour-packed marinade with peanut or cashew butter, soy sauce, and spices. Marinate chicken, tofu, or vegetables for a unique twist on your usual grilling routine.

3. Nut Butter Frosting:

Elevate your cakes and cupcakes with a nut butter frosting. Blend almond or cashew butter with icing sugar and a bit of milk for a rich, nutty topping.

Health Benefits of Nut Butters

Nut butters are not only delicious but also packed with nutrients. They are excellent sources of healthy fats, protein, vitamins, and minerals. Regular consumption can support heart health, provide sustained energy, and contribute to overall well-being.

Cooking with nut butters opens up a world of culinary creativity. Their rich flavours and creamy textures can enhance both sweet and savoury dishes. So next time you’re in the kitchen, reach for a jar of your favourite nut butter and experiment with these delightful recipes. Your taste buds will thank you!

Happy nut cooking!