Egg oral immunotherapy

Vickery, Brian P.

doi:10.1097/aci.0b013e3283535bae

Cited by 15 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, in recent years, several pilot studies and randomized clinical trials have been performed on oral immunotherapy (OIT) for egg allergy. A review summarizing the recent advances made in OIT for egg allergy suggested the efficacy of this approach [7], which was substantiated by a recent multicenter, randomized, clinical trial from the US [8]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Low-Allergenic Hydrolyzed Egg Induces Oral Tolerance in Mice

Hacini‐Rachinel¹,

Vissers²,

Doucet‐Ladevèze³

et al. 2014

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Background: Egg allergy is one of the most common food allergies in children. The standard therapy for egg allergy is strict avoidance. Yet, there is considerable clinical and scientific interest in primary or secondary prevention. A major drawback of oral tolerance (OT) induction protocols, however, is the possibility of severe side effects; thus, we have formulated a hypoallergenic egg product and demonstrate its in vivo capacity to modulate the immune system in the current study. Methods: Hydrolyzed egg (HE) was produced using a combination of moderate heat treatment and enzymatic hydrolysis. The capacity of HE to induce OT was tested in experimental models and compared to whole egg (WE). Delayed-type hypersensitivity (DTH) responses, immune markers and potential early markers of OT were analyzed. Results: Allergic responses, assessed by both DTH responses upon OVA challenge and serum OVA-specific IgE and IgG1, were decreased after treatment with HE and WE compared to the control group. Additionally, feeding WE and HE significantly decreased Th2 cytokine induction and cell proliferation, induced the activation of effector CD4+ T cells and increased numbers and percentages of ICOS+CD4+CD25+Foxp3+ cells. Furthermore, DO11.10 mouse experiments showed that HE contains other peptides than the OVA_323-339 peptide that are able to induce tolerance to OVA. Conclusions: Altogether, results showed that HE induces OT in mice in a dose-dependent manner. Due to its low allergenicity compared to WE, it may represent a safer alternative for OT induction in at-risk subjects or oral immunotherapy in allergic patients.

show abstract

Section: Introductionmentioning

confidence: 99%

“…A major drawback of OIT, however, is that side effects are common, which prevents 10-20% of patients from continuing with therapy [7]. Hydrolysis of food-derived proteins has been successfully performed leading to less allergenic products that still induce OT in vivo [15,16].…”

Section: Introductionmentioning

confidence: 99%

Low-Allergenic Hydrolyzed Egg Induces Oral Tolerance in Mice

Hacini‐Rachinel¹,

Vissers²,

Doucet‐Ladevèze³

et al. 2014

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…The efficacy of various types of OIT for children with egg allergy has recently been reported with favorable outcomes [14,18-21], though only few studies have been performed by placebo-control randomized manner [21,22]. One of the characteristics in our study was to select a population with a low likelihood of outgrowing the egg allergy including an untreated group as we attempted to indicate the efficacy of our regimen more strictly.…”

Section: Discussionmentioning

confidence: 99%

“…A further characteristic of our study was the long duration of follow-up, which facilitated the assessment of whether the children could achieve not only temporal remission but also clinically stabilized oral tolerance. It has been suggested that for children with moderate to severe egg allergy, a longer period (3 – 5 years) and/or a higher dose loading might be beneficial [21,22]. Indeed, in our study, some children who did not achieve oral tolerance induction by 1 year were able to achieve one by 2 years, and the achievement rate increased by nearly double (the number of patients who achieved temporal remission by 1 year: 9, those who achieved temporal remission by 2 years: 17).…”

Section: Discussionmentioning

confidence: 99%

Home-based oral immunotherapy (OIT) with an intermittent loading protocol in children unlikely to outgrow egg allergy

Sudo

Taniuchi

Takahashi

et al. 2014

All Asth Clin Immun

View full text Add to dashboard Cite

BackgroundHome based oral immunotherapy (OIT) for food allergy has often been used for young children in Japan, the majority of whom are believed to outgrow the allergy by the school age, therefore the true efficacy of the therapy has been controversial. The aim of this study was to evaluate the efficacy and safety of a newly developed slow- type home-based oral immunotherapy (OIT) regimen in children with hen’s egg (HE) allergy, who had low likelihood of outgrowing the allergy, with treatment involving only elimination diet.MethodWe retrospectively reviewed the medical records of 43 children with egg allergy (30 males; median age 6) who fulfilled Burks et al.’s criteria of being unlikely to outgrow the allergy. Thirty children who agreed to start OIT were assigned to the treatment group, and 13 who did not want to participate immediately were assigned to the untreated group; the patients underwent an elimination diet for 1 year, during which they were monitored. The OIT regimen involved the intake of the maximum tolerated dose 2 to 3 times a week at home, with initial dose introduction followed by dose build-ups with medical supervision. We statistically evaluated the rate of children who changed their threshold up to 32 g of egg – defined as, oral tolerance induction– in both the groups for 1 year and in the OIT group for 2 years, as well as the rate of children who fulfilled Savage et al.’s criteria of clinical tolerance after reaching the abovementioned remission stage.ResultsThe rate of children who achieved oral tolerance induction to 32 g of egg after 1 year in the OIT group (9/30) was significantly higher than that in the untreated group (0/13). The total rate within the OIT group was significantly increased from 9/30 at 1 year to 17/30 at two years without any severe adverse reaction; of the above 17 children, we followed 14 children, and noted that 11 of these were able to obtain clinical tolerance.ConclusionThe home-based OIT with an intermittent loading protocol was very safe and effective in children with a low likelihood of outgrowing egg allergy.

show abstract

“…Several well-designed studies, including randomization and placebo controls, have been reporting the effectiveness of immunotherapy for increasing tolerance levels to a variety of foods, suggesting that immunotherapy is a viable option for managing food allergies 7,8,9 . In this issue, the studies on egg 10 and milk 11 immunotherapy are reviewed. This has led to a paradigm shift in the field of food allergy, and strict avoidance may not be the only management strategy 12 .…”

mentioning

confidence: 99%