Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: a randomized controlled trial.

Abstract

BACKGROUND:

Treatment of severe egg allergy is avoidance of hen's egg (HE) and carrying self-injectable epinephrine. Specific oral tolerance induction (SOTI) seems a promising alternative treatment. However, some aspects of SOTI are still considered experimental.

METHODS:

We evaluated the efficacy and safety of an original 6-month SOTI protocol in children with very severe HE allergy using raw HE emulsion. Twenty children (age range: 5-11 yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6 months later. Control children were kept on an egg-free diet for 6 months and then underwent a second challenge.

RESULTS:

After 6 months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10 ml, but <40 ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5 ml (no tolerance). After 6 months, nine control children tested positive to the second challenge at a dose ≤0.9 ml of raw HE emulsion, and one reacted to 1.8 ml (SOTI vs. control group p<0.0001). All children in the SOTI group had side effects, but no child had a grade 5 reaction according to the Sampson grading.

CONCLUSION:

Six months of SOTI with raw HE emulsion resulted in partial tolerance, with regular intake, in a significant percentage of children with severe egg allergy.

• Authors: Iride Dello Iacono, Salvatore Tripodi, Mauro Calvani, Valentina Panetta, Maria Carmela Verga, Stefano Miceli Sopo
• Journal: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology (Pediatr Allergy Immunol) Vol. 24 Issue 1 Pg. 66-74 (Feb 2013) ISSN: 1399-3038 [Electronic] England
• PMID: 22957889 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2012 John Wiley & Sons A/S.

Chemical References

• Allergens
• Emulsions
• Immunoglobulin E

Topics

• Administration, Oral
• Allergens (administration & dosage, adverse effects, immunology)
• Anaphylaxis (immunology, prevention & control)
• Animals
• Chickens
• Child
• Child, Preschool
• Desensitization, Immunologic (adverse effects, methods)
• Double-Blind Method
• Egg Hypersensitivity (immunology, prevention & control)
• Eggs (adverse effects)
• Emulsions (administration & dosage)
• Female
• Humans
• Immune Tolerance (immunology)
• Immunoglobulin E (blood)
• Male
• Skin Tests
• Treatment Outcome