Rush Specific Oral Tolerance Induction in School-Age Children with Severe Egg Allergy: One Year Follow Up

Itoh, Naoka; Itagaki, Yasuharu; Kurihara, Kazuyuki

doi:10.2332/allergolint.09-oa-0107

Cited by 105 publications

(84 citation statements)

References 34 publications

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“…The maximum dose of OM in this OIT protocol was 0.151 g OM/kg of body weight (5.0 mg OM/mouse, mouse body weight 33 g). This amount is approximately the same as that used in human OIT (15). Thus, the result of the OIT protocol shows that the present OIT protocol may be applicable OIT for humans allergic to eggs.…”

Section: Discussionsupporting

confidence: 54%

“…It has been reported that rush OIT improved allergic responses in human patients (14,15). Itoh et al used rush OIT for severe allergy as a therapeutic treatment (15).…”

Section: Discussionmentioning

confidence: 99%

“…In slow OIT, the allergen dose is increased at home over 1-2 y (12, 13). In rush OIT, the allergen dose is increased in about 1-2 wk under intensive management and supervision in a hospital (14)(15)(16). In some studies, rush OIT was shown to improve allergy responses (14,15).…”

mentioning

confidence: 99%

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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: Discussionsupporting

confidence: 54%

“…It has been reported that rush OIT improved allergic responses in human patients (14,15). Itoh et al used rush OIT for severe allergy as a therapeutic treatment (15).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…A similar approach has also been used for hen's egg allergy. 20,22 Another approach to decrease the logistical burden of OIT has been to have subjects increase doses at home following an in-hospital rush protocol for milk allergy. 49 In this study, patients were given instructions on how to increase their doses and on how to treat specific symptoms with specific medications; notably, patients were instructed to use nebulized epinephrine followed by β-2 agonist for cough, wheeze, tightness of chest, or change in voice.…”

Section: Increasing Desensitization Efficacymentioning

confidence: 99%

Oral immunotherapy for the treatment of food allergy

Bégin

Chinthrajah

Nadeau

2014

Human Vaccines & Immunotherapeutics

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Rush Specific Oral Tolerance Induction in School-Age Children with Severe Egg Allergy: One Year Follow Up

Abstract: Our rush SOTI is a safe and effective treatment for severe food allergy since only a few weeks are needed to acquire tolerance. It would replace allergen avoidance as the treatment for food allergy.

Cited by 105 publications

References 34 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 the treatment of food allergy

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