Enzyme Potentiated Desensitisation

Objectives include:

  • To improve diet, allow a limited or normal contact with common allergens.
  • To phase out or discontinue various medications when free of symptoms.
  • The prevention of symptoms arising from newly acquired allergies.

Indications/Aims of EPD

EPD is used for any type of allergy, IgE/Type I or other sensitivities, including allergies to inhalants, food or chemicals, where simple measures of avoidance are impossible or extremely difficult.  Conditions, which respond to desensitisation range from common allergies, asthma, eczema, rhinitis, hay fever, urticaria, to masked allergies, when an allergic mechanism is suspected, such as chronic fatigue, arthritis, colitis or Crohn's disease, digestive problems, recurrent infections, irritable bowel, migraine, mood changes, paediatric and weight problems.

Investigations

Treatment is usually recommended when there is satisfactory proof of allergy. This can be obtained with standard tests, IgE, skin prick test, RAST, in the case of classic allergies like asthma, atopic eczema, hay fever and so on. Food or chemical allergies may require different tests, e.g. elimination & challenge diet, cellular test of type B food reactivities or "non-atopic" allergy.  It is often essential to assess one's nutritional needs by means of mineral and vitamin tests, before supplements can be recommended.

Administration

An injection of 0.05ml is given very superficially into the skin in a way to form a small blister. This method might cause a small local irritation; this ensures a slow absorption through the skin, minimising the risk of side-effects. This is the most frequently used approach.

Safety

With over 40 years of use and approximately 600,000 treatments, EPD has not caused one severe or life-threatening reaction. As there is a theoretical risk with any form of desensitisation, standard medications are on hand and ready to be used, at the time of treatment, for any allergies. Doctors using EPD are careful to follow protocols recommended by the manufacturers and will only administer the injections as frequently as necessary. The Medicines Control Agency has recognised that EPD does not have the same risks for severe reactions as the ordinary Incremental Desensitisation (discovered by Noon and Freeman in 1911).

Response

A pessimistic forecast is that EPD will fail in 20-25% of patients treated. The rest will experience variable degrees of improvement.  Audits place the effectiveness of EPD very high (80-90%), provided that instructions are followed strictly. The majority of failures are linked with patients who give up treatment too early or do not follow instructions, i.e. overwhelming the treatment with exposure to perfumes, wrong diet or pets. Depending on the duration of their condition prior to EPD, some patients start feeling better after their third or fourth injection but most will respond sooner. A small percentage take longer to see results. For this reason, failure of EPD can only be accepted if the environmental, dietary and nutritional advice have been followed meticulously and treatment has been received over a two-year period. To ensure a good response, instructions should be followed strictly. Occasionally, patients who did not benefit from their treatment during the first pollen season, will become immune to various seasonal allergens if given further booster doses during the second year. Information on clinical trials are available on request.

Origins-Availability

This method of treatment for prevention of allergies was invented by a brilliant immunologist Dr. Len McEwen, at St. Mary's Hospital, Paddington, a few yards from the point where penicillin was first discovered. EPD is manufactured in Berkshire, under absolutely sterile conditions; as it is an unlicensed product, i.e. not a drug, it is available on a "named patient" basis; EPD is not an alternative medicine. Since the early 1960's it has been used by a large number of doctors specialising in allergy in Europe (Austria, Germany, Italy, Greece) Canada, USA, Australia and New Zealand.

Description-Mode of Operation

The EPD comes in various cocktails of inhalants, moulds, foods or chemicals. Allergens are present in each cocktail in concentrations similar to a skin prick test or much less (1:1,000,000 - 1:10,000,000,000,000 of 1 ml). When mixed with a specific enzyme, beta-glucuronidase, the cocktail is activated and causes a gentle exposure of one's immune system to the allergens it contains, thereby initiating natural immunity. It is thought to stimulate the production of T-supressor cells, lymphocytes responsible to work against allergens. This explains the delayed therapeutic effect of EPD and the reason why repeated booster doses are necessary, until a good response is established.

Preparation

As EPD is highly diluted, it is important to avoid overwhelming it by being in contact with foods or inhalants it contains, at the time of the treatment. It is therefore recommended to reduce or avoid exposure to any items in the environment which might jeopardise the strength of the treatment. Hence it is reccommended to diet with low-risk foods around injection time; avoid perfumes and pets if you are being desensitised against inhalants. Some patients are advised to use specific combinations of anti-fungals and antibiotics prior to the time of treatment in order to reduce fungal and bacterial activity in the intestine.

For more information and a patient's personal experience of EPD

Girl having Enzyme Potentiated Desensitisation treatment