House CallApr/May 2014 Issue

Allergies Q & A: Chinese Medicine as Treatment for Food Allergies

Off the Bookshelf Traditional Chinese Medicine as Treatment for Food Allergies

© Ufo/Rf/Amana Images/CORBIS

© Ufo/Rf/Amana Images/CORBIS

Henry Ehrlich, co-author of Asthma Allergies Children: A Parent’s Guide and editor of AsthmaAllergiesChildren.com, has been exploring the work of Xiu-Min Li, MD, and her use of traditional Chinese medicine to treat people with food allergies. Li has developed Food Allergy Herbal Formula-2 (FAHF-2) at Mount Sinai School of Medicine in New York, where she is professor of pediatrics, allergy and immunology.

Ehrlich recently penned a book exploring Li’s research, Food Allergies: Traditional Chinese Medicine, Western Science, and the Search for a Cure. He spent months interviewing Li and her colleagues and poring over her published papers to tell the story of FAHF-2. Here, he talks with Living Without and shares insight into what he has learned about this pioneering work.

What is traditional Chinese medicine? And what is FAHF-2?

Henry Ehrlich Traditional Chinese medicine includes herbal medicine, acupuncture, mind-body therapy and dietary therapy. These are part of mainstream medicine in China and other Asian countries and are beginning to play a role in Western health care. Dr. Xiu-Min Li has taken a classical herbal formula, called Wu Mei Wan, used in traditional Chinese medicine for treating intestinal parasites, and she has adapted it into FAHF-2. Research published in The Journal of Allergy and Clinical Immunology has shown that FAHF-2 can reverse anaphylactic peanut allergy in mice. It is now in advanced human trials.

What can you tell us about how FAHF-2 works?

In a food-allergic person, the immune system pumps out too much immunoglobulin IgE, which is associated with the T-helper cell Th2. It’s supposed to be the least abundant immunoglobulin but in a severely food-allergic person, the level is ten to 100 times the normal level. Allergen-specific IgE comes to dominate placement on the high-affinity receptors on mast cells and basophils—known as effector cells—which contain mediators that are supposed to fight infectious agents. But instead, they attack otherwise harmless things like pollen or food. FAHF-2 helps ratchet down Th2 activity without compromising the Th1 mechanism, which protects against bacteria and viruses. This is immune modulation.

Dr. Li says she wants to “turn bad boys into good boys.” Getting the body to heal itself of allergies is a goal of traditional Chinese medicine generally. In Asthma Allergies Children, we say the most powerful weapon we have is the immune system itself. When that was written, I had no idea the extent to which Dr. Li’s work would embody this concept.

How is this treatment different from immunotherapy?

With immunotherapy, you introduce one allergen into the body so that more allergen-specific IgE is produced—so much of it, that it exhausts the capacity to produce more. Meanwhile, the Th1 cells are producing a blocking antibody called IgG4. Over time, this antibody replaces IgE on new effector cells. The hope is that after a period of immunotherapy, this process will result in tolerance.

In contrast, FAHF-2 appears to reset the immune system. The body no longer mistakes common foods for parasites. FAHF-2 alters the global immune response, so it could potentially treat a variety of allergies at once, including allergies to multiple foods.

What is the status of the human clinical trials being conducted now? Is there an estimated time when FAHF-2 might be fully approved?

To fully qualify as a drug, it takes years. The data from the latest phase of FAHF-2 trials is being analyzed and there will be other trials. The data point that Dr. Li is most proud of is that not a single adverse effect has been definitely related to the formula.

The FDA has approved a refined version of FAHF-2, called B-FAHF-2 for the Phase IIB clinical trials. Dosing will be six pills a day, rather than 30.

By the way, Dr. Li doesn’t use FAHF-2 in her private practice. She uses a variant, which, like all her medicines, is licensed as a dietary supplement.

Is Dr. Li exploring other options using FAHF-2?

There are new and exciting avenues of research. Dr. Li is working with Kari Nadeau, MD, PhD, associate professor at Stanford University School of Medicine Packard Children’s Hospital, Division of Immunology and Allergy, and chief investigator of food allergy studies at Stanford. They are going to try pre-treating study participants undergoing oral immunotherapy for anaphylaxis with B-FAHF-2 to reduce the reactions to allergen dosing and possibly to speed up desensitization. This has already been tried successfully with mice sensitized to peanuts and a variety of tree nuts.

Can people buy Chinese herbs and get some benefit for their allergy?

I wouldn’t recommend it. Quality and safety vary. Also, while there are many well-trained traditional Chinese medical doctors, Dr. Li has a special combination of scholarship, training and experience that allows her to successfully integrate both the Eastern and the Western medical traditions.

One important element of Dr. Li’s work is the fact that she treats the whole person, which is a tenet of traditional Chinese medicine. For example, you can argue convincingly that faulty digestion plays a big role in food allergies. In her private practice, Dr. Li treats digestion from the very beginning.

Do you think FAHF-2 could be a cure for food allergies?

We need a repertoire of treatments and this is part of that. It’s exciting to think about the possibilities that are opened up by Dr. Li’s work. No solution will work for everyone but the science supports a degree of optimism with this treatment.

Contributor Wendy Mondello lives in North Carolina.

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