Early sustained unresponsiveness after short‐course egg oral immunotherapy: a randomized controlled study in egg‐allergic children

Escudero, Carmelo; Río, Pablo Rodríguez del; Sánchez‐García, Silvia; Pérez-Rangel, Inmaculada; Pérez-Farinós, Napoleón; García-Fernández, Cristina; Ibáñez, María Dolores

doi:10.1111/cea.12604

Cited by 66 publications

(119 citation statements)

References 30 publications

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“…Despite the fact that control patients were younger and therefore they had more likely to develop natural tolerance. Our results are similar to those obtained by other researchers reporting 70%‐90% success with total desensitization, equivalent to one whole raw egg or one raw egg white …”

Section: Discussionsupporting

confidence: 92%

Egg oral immunotherapy in children (SEICAP I): Daily or weekly desensitization pattern

Martín-Muñoz

Belver

Lebrero

et al. 2018

Pediatric Allergy Immunology

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Section: Discussionsupporting

confidence: 92%

Egg oral immunotherapy in children (SEICAP I): Daily or weekly desensitization pattern

Martín-Muñoz

Belver

Lebrero

et al. 2018

Pediatric Allergy Immunology

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“…In the RCT employing just 4 months of egg OIT followed by 6 months of ingestion of 2-3 eggs per week, 5 (31%) of 17 patients treated with egg OIT demonstrated SU after 3 months of egg avoidance, compared to just 1 patient in the placebo group [36] . Similarly, after 3 months of egg OIT followed by 1 month of avoidance, DBPCFC demonstrated SU in 11 (37%) of the 30 children on OIT, compared to 1 amongst the 31 controls [37] .…”

Section: Eggmentioning

confidence: 90%

Oral Immunotherapy for Food Allergies

Feuille

Nowak‐Węgrzyn²

2016

Ann Nutr Metab

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Oral immunotherapy (OIT) is a promising investigational therapy for food allergy. Clinical trials in peanut, milk, egg, and wheat allergy provide evidence that OIT can effectively desensitize a majority of individuals to a food allergen. While a portion of subjects demonstrate sustained unresponsiveness, the majority regain sensitivity with allergen avoidance. The safety and tolerability of OIT continue to limit its use in some patients. Virtually all studies report adverse reactions that are more frequent during dose escalation but may also occur during maintenance therapy. Recent studies have identified adjunctive therapies (such as omalizumab) which may mitigate adverse effects. There is a paucity of data on the long-term safety and efficacy of OIT. Further study is required before OIT is ready for routine clinical practice. This review is intended to provide the reader with an up-to-date understanding of OIT, including its mechanisms, efficacy, safety profile, and potential utility in clinical practice.

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“…Neonatal skin barrier dysfunction predicts food allergy at 2 years of age, supporting the concept of transcutaneous allergen sensitization, even in infants Better than with OIT Better than with OIT OIT, oral immunotherapy; SLIT, sublingual immunotherapy; EPIT, epicutaneous immunotherapy. 1 Few studies explored less frequent (every other day of twice a week maintenance dosing therapy with promising results [96,97]). 2 OIT doses should be taken with meal; physical activity has to be avoided for 1 -2 h after ingestion; dosing should be withheld with illness (febrile illness, asthma exacerbation); dose reduction may be necessary during pollen season.…”

Section: Skin Barrier Restorationmentioning

confidence: 99%

Mechanisms of Tolerance Induction

Nowak‐Węgrzyn¹,

Chatchatee²

2017

Ann Nutr Metab

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Food allergy results from failure in oral tolerance that usually occurs in infancy or early childhood. Exposure to peanut and hen's egg via the inflamed and disrupted epithelial barrier in children with severe atopic dermatitis is a risk factor for the development of allergy to these foods and supports the hypothesis that epicutaneous exposure in the absence of oral feeding is an important pathway of allergic IgE sensitization in infants. In recent years, the collective evidence has pointed toward the protective effect of an early feeding with peanut and egg in children with eczema, taking advantage of the pathways underlying oral tolerance to counteract epicutaneous exposure. An addendum to the NIAID food allergy guidelines recommends introduction of peanut into the diet of 4- to 6-month-old infants with severe eczema or egg allergy as an effective strategy to prevent peanut allergy. Strategies aimed at restoring the skin barrier are currently explored as an alternative approach of prevention of eczema and allergic sensitization. Manipulation of the diet via supplementation with probiotics and prebiotics to restore the healthy gut microbiota represents another potential pathway to induction of tolerance in the gut. Oral, epicutaneous, and sublingual routes of food immunotherapy are promising and induce desensitization in the majority of the treated subjects with food allergy but are not proven to restore permanent oral tolerance. Rigorous multicenter randomized clinical trials are necessary to elucidate the optimal timing, dose, duration, as well as the preventive and therapeutic effects of these diverse approaches.

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Early sustained unresponsiveness after short‐course egg oral immunotherapy: a randomized controlled study in egg‐allergic children

Cited by 66 publications

References 30 publications

Egg oral immunotherapy in children (SEICAP I): Daily or weekly desensitization pattern

Egg oral immunotherapy in children (SEICAP I): Daily or weekly desensitization pattern

Oral Immunotherapy for Food Allergies

Mechanisms of Tolerance Induction

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