Israeli Breakthrough in Oral Immunotherapy Offers Hope for Life-Threatening Food Allergies
Peleg Beilin, a son of Reut from Givatayim, nearly died from a sesame allergy at just four months old when he first encountered tahini at daycare. Diagnosed at Ziv Medical Center with a life-threatening sesame allergy, Peleg’s family faced years of strict dietary vigilance, avoiding restaurants, takeout, and travel due to the prevalence of sesame in Israeli cuisine. Reut describes the challenge of completely avoiding sesame, especially in Israel where bread often contains it, leading her to bake homemade pita and bread.
Food allergies, including to milk, eggs, fish, sesame, nuts, and peanuts, affect about 5% of young children in Israel, up from 0.85% in 2000. These allergies can provoke severe immune responses, ranging from skin rashes to anaphylaxis and even death. Until recently, the only medical advice was strict avoidance and carrying an epinephrine injector. However, accidental exposures remain common, as Peleg’s severe reaction to a walnut at age three demonstrated.
A revolutionary treatment called oral immunotherapy (OIT) has emerged in the past two decades, involving gradual, controlled exposure to allergens to retrain the immune system. Dr. Liat Nachshon, a senior allergist at Shamir Medical Center, explains that the goal is to teach the immune system to accept the allergen and prevent dangerous reactions. The treatment lasts one to one and a half years, starting with supervised hospital dosing and monthly monitored dose increases at home.
Peleg began OIT at age five and was completely desensitized to sesame after three years. He is now undergoing treatment for walnut allergy and will next address cashew and pistachio allergies. A recent study at Shamir tracked 1,519 patients undergoing 1,704 treatments for various allergens, finding about 90% success in achieving full or partial tolerance, with three-quarters reaching full unrestricted consumption. However, the treatment carries risks of allergic reactions, including anaphylaxis, especially with milk allergy, which is more complex and less likely to achieve full tolerance.
Despite its success, OIT is not included in Israel’s health basket and costs families approximately 15,000 shekels per allergen treatment, with some needing multiple treatments. The waiting list at Shamir Medical Center currently spans four years. Reut urges families to invest in these life-saving treatments rather than ongoing supportive care. The protocol developed at Shamir has become a global reference point, offering hope and improved quality of life for thousands of families. Dr. Nachshon emphasizes that while OIT does not cure allergies, it restores patients’ confidence and control over their lives. For the Beilin family, the ability to enjoy foods like shawarma with tahini without fear is an emotional milestone and a testament to Israeli medical innovation.
