Oral Immunotherapy for Egg Allergy: A Double-Blind Placebo-Controlled Study, with Postdesensitization Follow-Up.

Abstract

BACKGROUND:

Oral immunotherapy (OIT) may be an effective treatment for food allergy in children. It is not clear if the OIT-induced effect is achieved by desensitization (transient state dependent on regular antigen exposure), or by tolerance (persistent condition where the ability to consume the food is retained even after a period of withdrawal).

OBJECTIVE:

The aim of this study was to investigate the efficacy of OIT-egg desensitization in a double-blind placebo-controlled study, and to evaluate if, after desensitization, tolerance can be maintained.

METHODS:

Children with egg allergy were randomized to OIT or placebo for 4 months. At the end of the controlled phase, a double-blind food challenge was repeated to confirm the achieved desensitization. Those subjects found to be desensitized were placed on an egg-containing diet for 6 months, followed by an egg avoidance phase for 3 months, when the food challenge was repeated to determine the maintained tolerance.

RESULTS:

A total of 31 children were randomized to OIT with dehydrated egg white (n = 17) or placebo (n = 14). Of the 17 active patients (1 dropout), 16 achieved desensitization and started the 6-month egg-containing diet. After 3-month of egg avoidance, 31% remained tolerant. In the control group, only 1 passed the final food challenge. Egg-specific IgG4 increased only in the active group. Five active OIT patients had side effects.

CONCLUSION:

Egg OIT results in desensitization in almost all subjects, although tolerance was maintained in only 1/3 of them after a 3-month period of withdrawal. Side effects were encountered, but the procedure appeared safe. In hen egg allergy, OIT is effective for desensitization.

• Authors: Lucia Caminiti, Giovanni B Pajno, Giuseppe Crisafulli, Fernanda Chiera, Mirella Collura, Girolamo Panasci, Paolo Ruggeri, Francesco Guglielmo, Giovanni Passalacqua
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) 2015 Jul-Aug Vol. 3 Issue 4 Pg. 532-9 ISSN: 2213-2201 [Electronic] United States
• PMID: 25725940 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Immunoglobulin G
• Immunoglobulin E

Topics

• Administration, Oral
• Child
• Child, Preschool
• Desensitization, Immunologic (adverse effects)
• Double-Blind Method
• Egg Hypersensitivity (blood, immunology, therapy)
• Female
• Humans
• Immunoglobulin E (blood)
• Immunoglobulin G (blood)
• Male