Efficacy of baked milk oral immunotherapy in baked milk–reactive allergic patients

Goldberg, Michael R.; Nachshon, Liat; Appel, Michael Y.; Elizur, Arnon; Levy, Michael B.; Eisenberg, Eli; Sampson, Hugh A.; Katz, Yitzhak

doi:10.1016/j.jaci.2015.05.040

Cited by 98 publications

(78 citation statements)

References 31 publications

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“…A recent study by Goldberg et al [51] sought to use this concept in patients who had been unable to tolerate milk OIT and were treated with OIT using baked milk. Unfortunately, in this highly select group of patients with severe milk allergy, only 3 of 14 achieved the primary outcome of tolerating 1.3 g of baked milk.…”

Section: Milk Oitmentioning

confidence: 99%

Oral Immunotherapy for Food Allergy

Wood

2017

J Investig Allergol Clin Immunol

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Food allergy is a potentially life-threatening condition with no approved therapies apart from avoidance and injectable epinephrine for treatment of acute allergic reactions. Oral immunotherapy (OIT) is an experimental treatment in which patients consume gradually increasing quantities of the food to which they are allergic in an attempt to induce some level of desensitization. While desensitization is possible in most patients, OIT carries significant risks for allergic reactions, and the ability to induce longer-term tolerance has not yet been established. This review focuses on selected studies of OIT for the treatment of common food allergies such as cow's milk, hen's egg, and peanut. Key words: Food allergy. Oral immunotherapy. Cow's milk. Hen's egg. Peanut. Desensitization. Tolerance. Sustained unresponsiveness. Skin prick test (SPT). Immunoglobulin E (IgE). Omalizumab. ResumenLa alergia alimentaria es una condición potencialmente mortal para la que no existen tratamientos aprobados, excepto la evitación y la epinefrina para tratar reacciones alérgicas graves. La inmunoterapia oral (OIT) es un tratamiento experimental en el cual los pacientes ingieren cantidades gradualmente crecientes del alimento al que son alérgicos, con el fin de inducir algún nivel de desensibilización. Si bien la desensibilización es posible en la mayoría de los pacientes, OIT conlleva riesgos importantes de reacciones alérgicas y la capacidad de inducir tolerancia a más largo plazo todavía no ha sido establecida. Este artículo de revisión se centra en una selección de estudios de OIT para el tratamiento de alergias a alimentos comunes, como son la leche de vaca, huevos de gallina y cacahuete. Palabras clave: Alergia alimentaria. Inmunoterapia oral. Leche de vaca. Huevo de gallina. Cacahuete. Desensibilización. Tolerancia. Falta de respuesta sostenida. Prick test. Inmunoglobulina. Omalizumab.

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Section: Milk Oitmentioning

confidence: 99%

Oral Immunotherapy for Food Allergy

Wood

2017

J Investig Allergol Clin Immunol

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“…For the 6 participants who continued with the protocol, there was a significant increase in challenge threshold to unheated milk. The results of this study suggest that the use of baked milk as OIT may be useful for increased threshold reactivity; however, for patients who are highly sensitive to milk, it may be less realistic as a method of attaining clinical tolerance to milk [55] . With these data, experts have recommended that for children already tolerating baked products, it is safe to continue regular ingestion at home.…”

Section: Extensively Heated Milk and Egg Dietmentioning

confidence: 89%

Oral Immunotherapy for Food Allergies

Feuille

Nowak‐Węgrzyn²

2016

Ann Nutr Metab

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Oral immunotherapy (OIT) is a promising investigational therapy for food allergy. Clinical trials in peanut, milk, egg, and wheat allergy provide evidence that OIT can effectively desensitize a majority of individuals to a food allergen. While a portion of subjects demonstrate sustained unresponsiveness, the majority regain sensitivity with allergen avoidance. The safety and tolerability of OIT continue to limit its use in some patients. Virtually all studies report adverse reactions that are more frequent during dose escalation but may also occur during maintenance therapy. Recent studies have identified adjunctive therapies (such as omalizumab) which may mitigate adverse effects. There is a paucity of data on the long-term safety and efficacy of OIT. Further study is required before OIT is ready for routine clinical practice. This review is intended to provide the reader with an up-to-date understanding of OIT, including its mechanisms, efficacy, safety profile, and potential utility in clinical practice.

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“…For example, in a recent study [39] for baked milk OIT in 14 patients with baked milk allergy only three were able to reach and tolerate the maintenance daily. What makes these three patients responsive to therapy while others are not in this trial and many other trials for immunotherapy emphasizes the fact that certain patients may require different protocols or methods of immunotherapy to achieve a desired level of desensitization.…”

Section: Personalized Approach To Food Desensitizationmentioning

confidence: 98%

Emerging Approaches to Food Desensitization in Children

Hamad

Burks

2017

Curr Allergy Asthma Rep

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Recent advancements in epicutaneous, sublingual, and oral immunotherapy for food allergy in the future may offer children with food allergy and their families a viable option to reduce risk or severity of anaphylaxis with phase III trials ongoing for two of these treatment modalities. Food allergy prevalence in children is estimated to be up to 8%. These children are at risk of significant allergic reactions and anaphylaxis. Food avoidance and use of antihistamines or epinephrine has been the standard of care for these patients. This approach also has a significant socioeconomic effects on patients and their families. Recent advancements in understanding food allergy have allowed for exploring new methods of treatment. There is an increasing interest in oral immunotherapy, epicutaneous immunotherapy, or sublingual immunotherapy for food allergy. There have been also innovative approaches to immunotherapy by modification of food allergens (to make them less allergenic while maintain their immunogenicity) or adding adjunctive treatments (probiotics, anti-IgE, etc.) to increase efficacy or safety.

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Efficacy of baked milk oral immunotherapy in baked milk–reactive allergic patients

Cited by 98 publications

References 31 publications

Oral Immunotherapy for Food Allergy

Oral Immunotherapy for Food Allergy

Oral Immunotherapy for Food Allergies

Emerging Approaches to Food Desensitization in Children

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