Lau-Chen's two daughters both have food allergies. Her older daughter, a 9-year-old, is allergic to shellfish, which isn't too hard to avoid, according to Lau-Chen. But feeding her 7-year-old girl, who is allergic to milk, egg, peanuts and tree nuts, poses a much bigger challenge.
"We've had three close calls with my younger daughter," Lau-Chen said. Her daughter has gone into anaphylactic shock — a serious allergic reaction, which can cause death if not treated immediately, often with a shot of epinephrine. "We need to carry medication everywhere we go — an EpiPen or an EpiPen Junior."
Lau-Chen's daughters are just two in a growing cohort of people with food allergies. According to the Centers for Disease Control and Prevention, the prevalence of children experiencing allergic reactions to food has risen nearly 2 percent since 1997.
It's an increase that has gotten the attention of the medical community, prompting studies such as ones now being conducted at El Camino Hospital.
Lau-Chen's younger daughter recently engaged in a double-blind allergy test to determine whether she might be a good candidate for a study led by Dr. Kari Nadeau of Stanford University. The Stanford Alliance for Food Allergy Research (SAFAR) is working with patients from the Lucile Packard Children's Hospital in an effort to come up with ways to help children overcome their allergies to food — and learn more about food allergies in the first place.
There are still many questions that remain unanswered when it comes to food allergies — in particular why exactly they occur and why they may be on the rise, according to Tina L.R. Dominguez, a physician assistant, clinical manager and trainer with SAFAR.
Dominguez said she and the researchers at SAFAR understand the mechanism behind food allergies — for some reason the body interprets certain foods as threats and attacks them with antibodies, which in some cases can cause the kind of swelling that will close up a person's throat and lead to asphyxiation. But it's not exactly clear why the body would think something as seemingly benign as a tree nut is a danger.
Researchers think that it may have something to do with the way food is grown, harvested and processed. Environment and genetics also are likely contributors.
"When you look at society and the way it was a generation before, things weren't mass produced in the way they are today," Dominguez said.
Genetic modification of food has been vastly expanded in the past generation or two. Processed food is pumped full of preservatives, artificial colors and flavors, and is subject to cross contamination from other foods and pollutants. Dominquez said she believes that all of those things have to play a factor in the rise of food allergies. "When you add up the amount of changes in manufacturing, all the environmental pollution, and you add the genetic component, that seems to be the combination that is causing some of these food allergies."
Research projects like SAFAR, and others around the country, are yielding results. According to Dominguez, it is possible to help the severely food allergic, like Lau-Chen's younger daughter, overcome their violent reactions to peanuts.
With the help of the doctors, nurses and scientists working at SAFAR, Lau-Chen's younger daughter — if selected — will undergo a process called "oral immunotherapy." If she is accepted to the study, she should eventually be able to eat a full serving of peanuts.
Oral immunotherapy, or OIT, is a process by which a food-allergic patient is slowly introduced to a larger and larger portion of the food to which they are allergic, Dominguez explained. Starting with an almost imperceptible portion, the patient's dose is steadily increased over a matter of months until he or she is able to eat a full serving of whatever had caused allergic reactions.
The process is still "experimental," according to Dominguez. And once someone has a resistance to a given food they have to keep eating a certain amount of that food every day in order to maintain that resistance — in other words there is no "cure."
The FDA has yet to approve oral immunotherapy and it can only legally be conducted in a highly regulated setting. "Safety has to be absolute," Dominguez said. "This isn't even allowed in clinics for allergists to do."
Everyone at SAFAR is trained to recognize the subtlest of symptoms of an allergic reaction, Dominguez said. If someone is administered too high of a dose of the food to which they are allergic, "you literally have minutes" to take action to avoid serious complications, including death, she said.
Despite the dangers of OIT, Lau-Chen is keeping her fingers crossed that her daughter will be accepted into the study.
"It would eliminate some of our daily fears." Lau-Chen said, speaking for her daughter and for herself. Both of them could breath easier knowing that they didn't have to worry about whether a meal may contain trace amounts of peanuts. Peanuts — which she said, are responsible for 58 percent of all deadly food allergy reactions. "It would be life-changing."