Moms love it for its simplicity; kids love it for its taste. Peanut butter and jelly sandwiches line the bottom of brown paper bags in cafeterias across the country -- it's a staple of elementary school lunches.
Yet many children are excluded from the universal experience for health reasons. At the moment, there is no treatment for peanut allergies. Managing peanut allergies comes down to avoidance and injectable epinephrine when a life-threatening allergic response begins.
The avoidance method could one day have an alternative, and Pittsburgh would have played a role. The Children's Hospital of Pittsburgh of UPMC is one of the participating centers of a worldwide study attempting to desensitize participants allergic to peanuts through wearing a patch containing a peanut protein. There are 10 participating centers in the United States, six in France, four in Canada, two in the Netherlands and two in Poland.
Other centers began the study late last summer, so Todd Green, the principal investigator for the study in Pittsburgh, expects preliminary results to be available in the next six months.
So far, the patch seems very safe, as it hasn't caused much bad reaction among patients at other centers, just some irritation, Dr. Green said. Gradually, it is hoped, the body can tolerate peanuts.
The success of the study could change the lives of millions of Americans. As many as 3 million individuals are allergic to peanuts in the United States, which is about 1 percent of the general population, according to Tom Wood, a fellow at the American Academy of Allergy, Asthma & Immunology.
About 1.5 percent of children are allergic, making experts believe that the allergy is becoming more common, Dr. Wood said.
Dr. Green said the goal of the study is to look at the safety and effectiveness of this patch in children and adults. A number of small studies are focusing on oral therapy to desensitize peanut allergies, although they are considered a high risk to the children tested.
The dosage applied to the top layer of skin depends on the randomly assigned groups of participants who will change the patch every 24 hours for one year. There are three different extremely small doses -- 50 micrograms, 100 micrograms and 250 micrograms -- and one placebo group, making four distinct groups. At the end of the study, Dr. Green will compare the reaction after 12 months of wearing the patch to the initial test.
Dr. Green said the worldwide study has finished selecting participants in the 5-to-11 age range, which includes four children from Pittsburgh. Now, the study is seeking those in the 12-to-55 age range until spots fill up. All the participants are screened to make sure they are sensitive to peanuts, which is proven by contact with about 1 1/2 peanuts or 444 milligrams.
Officials in France will notify Dr. Green when he should stop screening 12- to 55-year-old participants for the study.
Enrollees are compensated for time and travel associated with participating in the study, but most interest is fueled by desire to find a cure, Dr. Green said.
In the next few weeks, participants enrolled in Pittsburgh will begin wearing the patch for the next year, Dr. Green said.
One of those individuals is Luke Fabisiak, a sophomore at North Hills High School. Since suffering from a severe reaction to peanut butter when he was 3, his mother, Peggy Fabisiak, has made sure he did not come in contact with peanuts, which is life-threatening to him, again. She has had several conversations with administrators at her son's schools throughout the years.
Ms. Fabisiak of Ross said her son was uncomfortable with his allergy until he was in third grade when students became more sympathetic to him. Until that point, he was thought of as different than everyone else, especially during lunch, holiday parties and when students would bring in treats for their birthdays.
From baseball games where many eat peanuts to airplane rides where nut snacks are served, Luke must always be vigilant in avoiding the substance. This means carrying a bulky EpiPen everywhere to avoid a reaction that might constrict his breathing and could lead to death. An EpiPen, an autoinjector containing a single dose of epinephrine, can save his life within the few minutes necessary, Ms. Fabisiak said.
Luke said he agreed to participate in the study to hopefully help others with peanut allergies. He would like to see a treatment come because the allergy has had such an impact on his life.
"I think that if this can help put an end to the allergy, it would be a huge load off my shoulders and others," Luke said. "I wouldn't have to worry as much or be dependent on people knowing what to do if I have a reaction."
Although his situation has become easier, he admitted it was challenging when he was a young boy.
In most school districts, there is a peanut-free table for students to eat lunch, but some parents raise objection because they do not want their children to feel ostracized, said Michelle Marker, program director at The Nutrition Group, which handles food services for more than 130 school districts in Pennsylvania and Ohio.
In other districts, the entire school is peanut-free. With severe peanut allergies, all peanut butter products are substituted with sun butter, which is made from sunflower seeds, Ms. Marker said.
Only under severe circumstances, however, is a middle school or high school within a district completely peanut-free, Ms. Marker said.
Ms. Marker said school policies differ depending on the severity of cases within the district. Some children cannot have direct contact with peanuts while others can't even be in the same vicinity.
Fellow classmates are often the key to safety because children are told who has an allergy to avoid food sharing, Ms. Marker said.
"At a school the other day, a little boy raised his hand and said, 'I have a peanut butter sandwich, and he is allergic,' while pointing at someone in the class," Ms. Marker recalled. "He asked me, 'Can I move over to the other table?' The students really do want to help."
Perhaps one day, if the study is successful, there will be no need for peanut-free tables, strict policies or pointing at children with allergies within schools.
While the preliminary results will soon be available for the study, Dr. Wood cautioned those with peanut allergies from expecting an immediate turnaround. There will not be new treatment available in the next year or two.
"If this study is successful then there will be a larger study conducted," Dr. Wood said. "If that study sees good results, another larger study will need to be done. Potentially, in the next eight to 10 years, this could receive FDA approval."
Jessica Tully: email@example.com or 412-263-1601.