Toxin or treatment?

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Science  19 Oct 2018:
Vol. 362, Issue 6412, pp. 278-282
DOI: 10.1126/science.362.6412.278

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More than 3000 people worldwide, most of them children, have undergone peanut immunotherapy for a peanut allergy, with the goal of protecting them if they accidentally encounter the food. Others are trying immunotherapy for allergies to milk, eggs, and tree nuts. Two biotechnology companies are racing to introduce a peanut-based capsule or patch, and both plan to apply for approval from the Food and Drug Administration (FDA) this year. In a field that for decades has had nothing to offer patients beyond avoidance, immunotherapy marks a seismic shift. Fear that it might cause harm is mingling with euphoria that children living constrained lives could be set free. Doctors who offer immunotherapy describe families eating in Chinese restaurants for the first time and home-schooled children rejoining their peers. But like many medical firsts, the therapy is not perfect. Physicians fret about the therapy's rigors—treatment must continue indefinitely—and its risks, which for oral immunotherapy include the same allergic reactions it aims to prevent.