Oral food desensitization in children with IgE‐mediated hen’s egg allergy: a new protocol with raw hen’s egg

Meglio, Paolo; Giampietro, P. G.; Carello, Rossella; Gabriele, Ida; Avitabile, Simona; Galli, Elena

doi:10.1111/j.1399-3038.2012.01341.x

Cited by 99 publications

(142 citation statements)

References 30 publications

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“…Nurmatov et al reported that OIT can promote allergen desensitization, but the risk of local adverse reactions increased with OIT in a metaanalysis (4). Failure of OIT, in which allergen desensitization was not achieved, has also been reported (16,31). In this experiment, the allergic response and some allergy biomarkers in the OIT-treated mice were found to be worse than those of the non-treated mice.…”

Section: Discussionmentioning

confidence: 58%

Rush Oral Immunotherapy Does Not Reduce Allergic Response in Mice with Mild Allergy to Egg White Ovomucoid

Maeta

Kaji

Nagaishi

et al. 2015

J Nutr Sci Vitaminol

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Summary Oral immunotherapy (OIT) is a promising therapeutic approach for treating food allergy. Past studies have shown that OIT reduces allergic response only in severe allergy model mice. We worked to establish mild allergy model mice, and investigated whether 'rush' OIT for 10 d improved the allergic response and biomarkers in these mice. Balb/c mice were sensitized to ovomucoid (OM) in alum. The rush OIT was done for 10 d. Oral OM challenge was used to determine the impact of OIT on the allergic response. We measured allergic biomarkers, such as vascular permeability in the skin, plasma levels of total IgE, OM-specific IgE, IgG1 and IgG2a and cytokines in splenocyte culture supernatant. OIT for 10 d did not improve allergy symptoms and increased vascular permeability. Total IgE in the plasma of OIT-treated mice was significantly higher than in that of non-treated mice. OM-specific IgG1 and IgG2a plasma levels were not significantly different between OIT-treated and non-treated mice. Among the cytokine secretion of splenocyte from OITtreated mice, IFN-g and IL-10 were significantly lower than in non-treated mice, and IL-4 and IL-5 were significantly higher. Total TGF-b in the OIT-treated group was not detected. The IFN-g/IL-4 ratio of the OIT-treated group was about 1/8 that of the non-treated group. OIT for 10 d was not effective and some biomarkers showed negative responses in the mild allergy model mice. We suggest OIT should be used very carefully as this treatment carries a risk of worsening allergy symptoms for mice with mild allergy. Key Words oral immunotherapy, food allergy, allergy model mice Food allergies affect about 3% of the overall population and up to 4-6% of children (1-3). In recent times, the prevalence of reported food allergy has increased 18% among children under 18 y of age (2, 3). Dietary avoidance of specific allergens is recommended as the first-line approach in the management of food allergy (1, 2). Recently, oral immunotherapy (OIT) has been studied as a new treatment for food allergy (2,4,5). OIT uses small amounts of food allergen to desensitize the patient. However, OIT is not often recommended because it carries the risk of increasing allergy symptoms (2, 6).In Japan, egg allergy has been reported as the most prevalent food hypersensitivity in the pediatric population, exceeding cow's milk allergy (7). Ovalbumin (OVA) and ovomucoid (OM) were identified as egg white allergen epitopes, constituting about 54 and 11% of egg white protein, respectively (8,9). OM is heat resistant and has high allergenicity (10, 11). It is a well-known trypsin inhibitor (8). This suggested that OIT for OM (egg)-specific allergy patients may be a highly effective treatment and a pathway to allergen tolerance.As research in this area has been limited, there is inadequate evidence to establish proper OIT protocols, such as allergen dosage, escalation, duration of therapy and method of administration (2). OIT protocols are categorized as either 'slow' or 'rush.' In slow OIT, the allergen dose is increas...

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Section: Discussionmentioning

confidence: 58%

Rush Oral Immunotherapy Does Not Reduce Allergic Response in Mice with Mild Allergy to Egg White Ovomucoid

Maeta

Kaji

Nagaishi

et al. 2015

J Nutr Sci Vitaminol

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“…Other studies of egg OIT included the small RCTs by Dello Iacono et al and Meglio et al, who reported desensitization rates of 80%-90% in children with severe egg allergy, and 2 studies using rush protocols with desensitization induced in as few as 5 days [32][33][34][35].…”

Section: Egg 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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“…This appears particularly suitable for cow's milk (CM), hen's egg (HE), and peanut allergies. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Several clinical studies on the oral administration of allergy foods are available, and some trials are currently under way to better define indications, contraindications, and practical aspects. Of note, there is no specific study for non-IgE-mediated food allergy, such as food proteininduced enterocolitis syndrome.…”

mentioning

confidence: 99%

Oral Immunotherapy for Treatment of Immunoglobulin E-Mediated Food Allergy: The Transition to Clinical Practice

PajnoGiovanni

CoxLinda

CaminitiLucia

et al. 2014

Pediatric Allergy, Immunology, and Pulmonology

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Today, there is neither an effective nor an active treatment for food allergy. Allergy immunotherapy has been proposed as an attractive strategy to actively treat food allergy. Oral immunotherapy (OIT), also known as oral desensitization, is a method of inducing the body's immune system to tolerate a food that causes an allergic overreaction. It has been studied for the use in treatment of immunoglobulin E-mediated food allergy to the most common foods, including milk, egg, and peanut. OIT has been able to desensitize subjects to varying degrees. However, many questions remain unanswered, including efficient formulation, optimal dosing, and induction protocol to achieve full tolerance, transition of OIT to clinical practice, and maximal safety profile. This review focuses on the use of OIT as a new and active treatment for food allergy. The possibility of transition of OIT to clinical practice represents, in this field, the next pivotal step with the goal of improving the quality of life of patients with food allergy and their families. O ver the past few decades, the prevalence of allergic diseases has increased, especially in developed countries. While the prevalence of asthma has stabilized and the prevalence of eczema appears to be slowly decreasing, the prevalence of food allergy and anaphylaxis continues to rise.

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Oral food desensitization in children with IgE‐mediated hen’s egg allergy: a new protocol with raw hen’s egg

Cited by 99 publications

References 30 publications

Rush Oral Immunotherapy Does Not Reduce Allergic Response in Mice with Mild Allergy to Egg White Ovomucoid

Rush Oral Immunotherapy Does Not Reduce Allergic Response in Mice with Mild Allergy to Egg White Ovomucoid

Oral Immunotherapy for Food Allergy

Oral Immunotherapy for Treatment of Immunoglobulin E-Mediated Food Allergy: The Transition to Clinical Practice

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