FAHF-2 Chinese herbal formula for peanut allergies

Never has such a small, modest legume been so feared as the peanut for the allergic person. It's notorious for creating significant anaphylaxis reaction in those susceptible.

Food allergies such as this one are caused by an excessive immune response mediated by IgE. Symptoms typically appear within several minutes and can include abdominal pain, diarrhea, vomiting or an anaphylaxis reaction involving throat swelling and rash.

Treatments that have been explored include extended courses of injecting minute amounts of peanut protein, or administering small amounts of peanut protein orally to desensitize the immune system. These approaches have been met with overwhelming indifference. In the case of the injected proteins, a subject was killed instantly by a miscalculated dose that put an end to that investigation. In the case of oral desensitization, it's a long and slow process, but has made its way into regular clinical application For many it's too time consuming or too expensive. It requires going into the doctor weekly for more than 40 weeks. 

Our understanding of how these allergies occur within a Chinese Medical paradigm would be an interesting discussion. But, an article in the Journal of Allergy and Clinical Immunology might help answer that question for me.  

Some serious rockstars (Srivastava, Dr. Li and friends) at Mount Sanai School of Medicine have tested an herbal formula that was able to entirely eliminate the anaphylaxis reaction in mice with peanut allergies. The formula, called "Food Allergy Herbal Formula" (FAHF for short), and it's successor FAHF-2 are modified versions of Wu Mei San. The initial formulation included xi xin and fu zi, FAHF-2 did not, but was still effective. Other researchers in other facilities took this and ran with it, and there have been and are several studies all over examining this effect and trying to understand it. (here's the study: http://www.ncbi.nlm.nih.gov/pubmed/15637565 not sure if there is a full text version out there, but if someone finds one could you post a link to it in the comments? I have the full text version so I'll try to summarize all the important details :) 

There are actually a lot of really interesting things to learn from these papers. Not the least of which being that they could get rid of a food allergy! But also, how exactly did they get mice to be allergic to peanuts in the first place? And what does that tell us about the allergic process in general? Not only that, but in the study we are examining they also did some tinkering with the murine immune system prior to the study, depleting the CD4 T cells in some mice and the CD8 T cells in other mice, and neutralizing the interferon gamma in a third set. This makes it possible to identify which aspects of the immune function the herbal formula acted through.

So I know it's the first thing you want to know, so I'll tell you now here are the ingredients, it's a modified Wu Mei San:

Prunus Mume

Zanthoxylum schinifolium

Angelica sinensis

Zingiber officinalis

Cinnamomum cassiae

Phellodendrom chinense

Coptis chinensis

Panax ginseng

and Ganoderma lucidum

and the Chinese:

Wu Mei

Cang Er Zi

Dang Gui

Sheng Jiang

Gui Zhi

Huang Bai

Huang Lian

Ren Shen

and Ling Zhi.

Here are the juicy tidbits:

First an immune hypersensitivity to peanuts was established. The specifics about how that happened is interesting. Here's a previous study that looked at how this is done: http://www.ncbi.nlm.nih.gov/pubmed/21762973. The authors found that in order for an antigen to result in an allergic response it needed to be administered with an adjuvant (read "toxic ingredient") to completely freak out the immune system. In the absence of a wickedly toxic tag-along these antigens could not create an allergic reaction. In these mice they mixed cholera toxin with pureed peanuts and fed it to the mice over a 5 week period. When they fed these mice plain old peanuts at week 14 they had increased histamine response, lower temperature, and peanut specific IgE and IgG indicating indeed they now had a peanut allergy. (did we need more reasons to avoid toxins in children and breastfeeding mothers, anyway?)

They administered 64 mg of the herbal mixture twice daily for 7 weeks (from week 8 through week 15). The ratio of each herb in the final formula isn't available in this paper, but is published in "phytotherapy research." I've requested a full text from the author...fingers crossed. I'll let you know if I find out. 

So in the FAHF-2 treated mice the peanut allergy was completely abolished for 40 weeks and even at up to 90 weeks they had only a very mild reaction. The sham group had significant reaction to the peanut challenge at every testing (done 7 times over 50 weeks) with "near fatal reactions." (In fact one mouse did die from the peanut allergy challenge at week 40. Our hats go off to him in gratitude as he joins a long list of mice suffering for the sake of our health going all the way back to the tortured specimens of Hans Selye.) 

The discussion section suggested the benefits are a result of a relative increase in the TH1 division of the immune system (demonstrated by the attenuation of the FAHF-2 effect with neutralization of interferon gamma, and with the depletion of CD8 cells.)

There is currently a human trial going on using FAHF-2 in peanut allergies with promising preliminary results. The ability to rebalance an imbalanced Th1/Th2 immune system is a significant accomplishment with far reaching implications. It is also a useful piece of information as we consider which herbal formulas fit our patient's presentations. It is disturbing that this information isn't spreading quickly across our professional circles. A repurposing of our medicine with this sort of clinically validity is big news for us, and we should be the first to know, not the last. It's an exciting and valuable opportunity to gain a more nuanced understanding of how our herbs influence the immune system in general. It also has repercussions in how we approach clinical problem solving. It echos teachings from Heiner Fruehauf that urge us to reframe our idea of parasite, or Gu patterns as encompassing a wider range of conditions involving systemic immune dysfunction and chronic illness. 

For more information on Gu syndrome look at Heiner's stuff here: 

http://www.prodseminars.net/product/gu-syndrome-unique-strategies-treatment-chronic-fatigue-syndrome-fibromyalgia-lyme-disease-p

and here: http://www.classicalchinesemedicine.org/wp-content/uploads/2010/04/fruehauf_guinterview.pdf

For a great blog on food allergies and the experience of a human subject in the FAHF-2 human trial:

http://foodallergybitch.blogspot.com/

And here's a link to the an article by Jake Fratkin on Dr. Li's work on allergic conditions including this formula:

http://www.acupuncturetoday.com/archives2005/dec/12fratkin.html