Successful Oral Desensitization in Sesame Allergy in an Adult Woman

Paschoalini, M Costa; Bernardes, A F; Buzolin, M.; Zollner, Ricardo de Lima; Mansour, Eli; Velloso, L. A.; Yang, Ariana Campos

doi:10.18176/jiaci.0427

Cited by 5 publications

(11 citation statements)

References 8 publications

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“…It is one of the possible reasons for 100% efficacy of the present protocol regarding the development of tolerance for target doses above 5,000 mg. Further, no severe side effects and no need for epinephrine at all stages of the treatment may be attributed to the use of omalizumab as an adjuvant. In another study, Costa-Paschoalini et al 24 reported a 48-year-old white woman with anaphylaxis or skin reactions to sesame-rich foods beginning at the age of 27 years. The desensitization process was done in four phases started using diluted crude white sesame extract with 0.0001 mg up to 10 mg, 5 doses per day.…”

Section: Discussionmentioning

confidence: 99%

“…Combining omalizumab with allergen immunotherapy increases the clinical and safety benefits. 24 Accordingly, we also used pretreatment with omalizumab as well as antihistamine in the protocol of this study to enhance the safety of treatment by considering the severity of reactions in the initial history and OFC at baseline. In this study, no patient, despite a history of severe anaphylactic reactions in the history and at OFC, showed anaphylactic reaction at any of the build-up and maintenance phases (without complications) and all treatments were safe.…”

Section: Discussionmentioning

confidence: 99%

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The Effectiveness of Oral Immunotherapy in Patients with Sesame Anaphylaxis using Omalizumab

et al. 2022

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in sesame allergy. 3 Although double-blind placebo oral food challenge (OFC) is the gold standard test for sesame allergy diagnosis, 1 on the basis of our previous study, other diagnostic methods such as prick test (SPT), skin prick to prick (SPP), specific IgE (sIgE), and finally, SPP may be suggested for diagnosis of those patients who cannot perform OFC. 4 Owing to the lack of a confirmed protocol and the increased sesame consumption in recent years, the true rate of sesame allergy may be higher in Iran. 5,6 Clinical manifestations range from S esame allergy is the most common allergy to seeds and its prevalence is increasing worldwide. 1 It has been recently estimated that sesame allergy affects 0.23% of US children and adults. A smaller, population-based study performed more than a decade ago introduced sesame as a food allergen, influencing about 0.1% of US children and adults. It shows the prevalence of sesame allergy is increasing. 2 Anaphylaxis is a life-threatening systemic, rapid onset reaction that its management is a clinical emergency, especially

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Oral Immunotherapy in Patients with Sesame Anaphylaxis using Omalizumab

et al. 2022

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show abstract

“…It is one of the possible reasons for 100% e cacy of the present protocol regarding the development of tolerance for target doses above 5,000 mg. Further, no severe side effects and no need for epinephrine at all stages of the treatment may be attributed to the use of omalizumab as an adjuvant. In another study, Costa-Paschoalini et al (20) reported a 48-year-old white woman with anaphylaxis or skin reactions to sesame-rich foods beginning at the age of 27 years. The desensitization process was done in four phases started using diluted crude white sesame extract with 0.0001 mg up to 10 mg, 5 doses/d.…”

Section: Discussionmentioning

confidence: 99%

“…Combining omalizumab with allergen immunotherapy increases the clinical and safety bene ts (20). Accordingly, we also used pretreatment with omalizumab as well as antihistamine in the protocol of this study to enhance the safety of treatment by considering the severity of reactions in the initial history and OFC at baseline.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of oral immunotherapy in patients with Sesame anaphylaxis using Omalizumab

Salari

Bemanian

Fallahpour

et al. 2021

Preprint

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Objective Sesame allergy is the most prevalent allergy to seeds. Oral immunotherapy (OIT) is defined as continuous consumption of an allergen at special doses and time. Omalizumab (Anti-IgE) increases tolerance to allergens used in OIT. This study evaluated the effectiveness of a new sesame OIT protocol in patients with sesame anaphylaxis in combination with omalizumab. Methods In this prospective open-label interventional trial study, 11 patients with a history of sesame anaphylaxis were enrolled after approval by Oral Food Challenge (OFC) test. At baseline, skin prick test (SPT) and skin prick to prick (SPP) test were performed. Serum sesame-specific IgE (sIgE) levels were measured. The maintenance phase was continued at home with daily sesame intake for 4 months. At the end of month 4, the OFC and above-mentioned tests were repeated to evaluate the treatment effectiveness. Results All 11 patients who underwent sesame OIT after 4 months could tolerate a dietary challenge of 22 ml tahini (natural sesame seed, equal to 5,000 mg of sesame protein and higher) and the average of wheal diameter in the SPT and SPP tests significantly decreased after desensitization. Conclusion This OIT protocol may be a promising desensitization strategy for patients with sesame anaphylaxis. Also, omalizumab obviously reduced the severity of reactions.

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“…The first case published with regard to solo sesame oral immunotherapy was published in 2019. 16 An adult woman with sesame allergy that resulted in seven episodes of anaphylaxis presented with negative IgE sesame test result but with a positive skin test result to tahini and sesame seed. The first phase of immunotherapy can be seen in Table 3 .…”

Section: Immunotherapymentioning

confidence: 99%

A practical focus on sesame allergy and a brief review of other seed allergies

Kaman

Factor

2022

Journal of Food Allergy

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Although seed allergies are relatively rare, sesame allergy has been increasing worldwide and is typically persistent in most patients. Because allergen labeling laws, until just recently, have not required the declaration of sesame as a major allergen, there is a clear need to better understand and potentially treat this food allergy. Although blood and skin prick testing for sesame have limited predictive value, this improves with the use of component diagnostics and skin-prick test with fresh sesame. A thorough history and oral food challenge should be used to diagnose sesame allergy. Treatment of sesame allergy with oral immunotherapy has been demonstrated to be safe and effective in case reports, and in at least one controlled study with a published sesame oral immunotherapy protocol. There is minimum literature with regard to management of other seed allergies.

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Successful Oral Desensitization in Sesame Allergy in an Adult Woman

Cited by 5 publications

References 8 publications

The Effectiveness of Oral Immunotherapy in Patients with Sesame Anaphylaxis using Omalizumab

The Effectiveness of Oral Immunotherapy in Patients with Sesame Anaphylaxis using Omalizumab

The effectiveness of oral immunotherapy in patients with Sesame anaphylaxis using Omalizumab

A practical focus on sesame allergy and a brief review of other seed allergies

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