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

Abstract

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.

Specific Immunotherapy in Food Allergy — Towards a Change in the Management Paradigm

“…There is evidence that this new approach is changing the management paradigm in food allergy, and in our opinion, like other authors [180], possibly it´s time for the practice of SOTI in medical centers with medical staff trained and under secure supervision of his risks.…”

Children who were treated with oral immunotherapy for cows' milk allergy showed long‐term desensitisation seven years later

“…However, many studies have reported achieving encouraging results using oral immunotherapy (OIT) to treat CMA or hens' egg allergies (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Meta-analyses have shown that studies to date have included small numbers of patients (13)(14)(15) and some of them have also included toddlers, which is a stage when milk allergies often resolve themselves naturally (6,11). Dosing protocols have varied from small allergen amounts that aim to protect against accidental exposures to large allergen amounts that aim to induce tolerance (14)(15)(16).…”

Bioanalytical Methods for Food Allergy Diagnosis, Allergen Detection and New Allergen Discovery

“…However, allergen avoidance, particularly in case of food allergies and commercially prepared food, is difficult to be completely accomplished: 40-100% of deaths due to food anaphylaxis arise from the consumption of meals, which were prepared away from home [60]. Therefore, a strict control of the allergen content in alimentary products and proper labeling should be constantly provided together with respective legal regulation [64].…”