Oral immunotherapy for food allergy in children

Current Opinion in Allergy and Clinical Immunology

Volumn 8, Issue 6, 2008, Pages 553-556

  Beyer, Kirsten ^a   Wahn, Ulrich ^a  

^a HUMBOLDT UNIVERSITY   (Germany)

Author keywords

Food allergy; Oral desensitization; Oral immunotherapy; Specific oral tolerance induction; Tolerance development

Indexed keywords

ADRENALIN; ANTIHISTAMINIC AGENT; EGG PROTEIN; FOOD ALLERGEN; IMMUNOGLOBULIN E; IMMUNOGLOBULIN G; IMMUNOGLOBULIN G4; IMMUNOMODULATING AGENT; SALBUTAMOL; STEROID;

ABDOMINAL PAIN; ALLERGIC REACTION; CLINICAL TRIAL; DESENSITIZATION; DOSE RESPONSE; DRUG DOSE ESCALATION; DRUG DOSE INCREASE; DRUG WITHDRAWAL; EGG ALLERGY; HOME CARE; HUMAN; IMMUNOLOGICAL TOLERANCE; IMMUNOTHERAPY; MILK ALLERGY; PEANUT ALLERGY; PRIORITY JOURNAL; PRURITUS; REVIEW; SIDE EFFECT; SNEEZING; TREATMENT OUTCOME; UNSPECIFIED SIDE EFFECT; URTICARIA; WHEEZING;

ADMINISTRATION, ORAL; ADULT; ALLERGENS; ANIMALS; CATTLE; CHILD; CLINICAL TRIALS AS TOPIC; DESENSITIZATION, IMMUNOLOGIC; FOOD HYPERSENSITIVITY; HUMANS; IMMUNE TOLERANCE; IMMUNOGLOBULIN E;

EID: 56749154092     PISSN: 15284050     EISSN: 14736322     Source Type: Journal    
DOI: 10.1097/ACI.0b013e32831952c8     Document Type: Review

References (20)

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10. Meglio P, Giampietro PG, Gianni S, Galli E. Oral desensitization in children with immunoglobulin E-mediated cow's milk allergy - follow-up at 4 yr and 8 months. Pediatr Allergy Immunol 2008; 19:412-419. Meglio et al. recently published a 4-year follow-up of their oral immunotherapy trial in children with IgE-mediated cow's milk allergy published 2004. This is the first long-term follow-up in children with cow's milk allergy. They showed that clinical tolerance induced by oral immunotherapy persists with time. Unfortunately, no control group was investigated.
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13. Staden U, Rolinck-Werninghaus C, Brewe F, et al. Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction. Allergy 2007; 62:1261-1269. Staden et al. published the first randomized, controlled trial in children with IgE-mediated and challenge-proven cow's milk or hen's egg allergy. In their study on 45 patients, complete tolerance was achieved in one-third of the children in both groups: the oral immunotherapy and the control group. Therefore, the authors suggested that oral immunotherapy does not change the natural course of cow's milk or hen's egg allergy in young children. However, children who were tolerant with regular intake or to smaller amounts of allergen might have the advantages of an increased threshold dose for allergic reactions. Therefore, oral immunotherapy might result in a substantially reduced risk of severe allergic reactions after accidental ingestion of the allergen in children who gained partial tolerance.
14. Longo G, Barbi E, Berti I, et al. Specific oral tolerance induction in children with very severe cow's milk-induced reactions. J Allergy Clin Immunol 2008; 121:343-347. Longo et al. recently published an excellent controlled study in children with very severe persistent cow's milk allergy in order to study safety and efficacy of oral immunotherapy. Sixty children were assigned in either a therapy or control group. After 1 year, 36% children in the therapy group had become completely tolerant, whereas in the control group, all children were still cow's milk allergic. An additional 54% of the children in the therapy group could take 5-150 ml of cow's milk without adverse reactions. Side effects were common under oral immunotherapy but controllable with adequate medications.
15. Staden U, Blumchen K, Blankenstein N, et al. Rush oral immunotherapy in children with persistent cow's milk allergy. J Allergy Clin Immunol 2008; 122:418-419. Recently, Staden et al. published a new approach for oral immunotherapy using a rush protocol. After 1 week of rush immunotherapy, six out of nine children with persistent IgE-mediated and challenge-proven cow's milk allergy could ingest 120 ml of cow's milk without clinical reactions. During the rush oral therapy, side effects were common but controllable with adequate medications.
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