Fighting Food Allergy With Food: Eleven-Year Experience With Oral Immunotherapy For Food Allergy (OIT)

Abstract

The components of agricultural products vary due to variations in growing conditions and harvest time. Protein concentration standardization of OIT foods appears to be a rational scientific approach to food allergy treatment. There is, however, no study demonstrating that variations in the concentrations of allergenic proteins during OIT are a cause of treatment associated adverse events (AEs). METHODS: Retrospective record review of patients receiving POIT approved by the North Texas IRB. OIT was administered according to modifications of previously reported protocols. RESULTS: 862 food allergic patients have been treated with eighteen different commercially available foods. For two foods, a single product was used for desensitization. Eight foods routinely used two different products, five foods used three products and three foods used more than three products. With the notable exception of wheat, OIT AEs were not associated with changes in food product. CONCLUSIONS: The only common factor among the different products is an equivalent total protein content based on the USDA Nutrient Database. If product variations don't cause AEs, then the clinical impact of variations between different samples of the same product are trivial and don't make a difference. OIT product standardization solves a theoretical problem that doesn't exist in the real world. Requiring OIT product standardization will increase costs and postpone the availability of treatment. It is theoretically possible that variety in the foods used for OIT may provide a more appropriate desensitization reflective of the foods that may be encountered by desensitized patients.