Oral and sublingual immunotherapy for egg allergy

Romantsik, Olga; Tosca, Maria Angela; Zappettini, Simona; Calevo, Maria Grazia

doi:10.1002/14651858.cd010638.pub3

Cited by 52 publications

(88 citation statements)

References 48 publications

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“…OIT has been demonstrated to be an effective treatment option to induce desensitization in patients with food allergy . Previous randomized controlled studies using home‐based protocols with various increment rates have reported lower total desensitization rates: Staden et al reached 2.8 g protein of lyophilized hen's egg powder in 7 of 11 (48%) patients in a mean induction period of 7 months; Moriset et al reached only 7 g of raw egg white (0.77 g proteins) after 6 months of treatment in 69.4% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Oral immunotherapy (OIT) has been shown to be an effective treatment to induce desensitization in patients with egg allergy . However, OIT is a long‐term treatment with associated dose adverse reactions (DARs), which are typically related to the buildup desensitization phase, requiring close medical monitoring. Rush OIT protocols are shorter, but they have been associated with more frequent and severe DARs than slower protocols .…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…The methodological quality of RCTs was assessed according to the Cochrane risk of bias approach [21], using published risk of bias assessments from systematic reviews, whenever available [22][23][24]. For case series, the Institute of Health Economics Quality Appraisal of Case Series Studies Checklist was applied [25].…”

Section: Selection Of Clinical Studies and Assessment Of Their Methodmentioning

confidence: 99%

“…There is no convincing evidence of a clinically significant difference between food allergens in terms of safety and efficacy outcomes in OIT for the treatment of IgEmediated food allergy. Therefore, all recommendations in these CPGs are generally applicable to all food allergens, unless there is specific evidence to demonstrate otherwise This recommendation is based on the principle of equity of eligibility It is supported by large amount of consistent clinical evidence, considering the absence of demonstrated lack of efficacy or of a consistent safety issue for any specific food despite a large number of clinical studies for a variety of foods [22][23][24][29][30][31][32][33][34][35][36][37][38]. Level of evidence: HIGH It is also supported by the lack of biological plausibility that the mechanism of OIT would differ from one allergen to another.…”

Section: Ethical Imperative Data or Other Considerations In Support mentioning

confidence: 99%

CSACI guidelines for the ethical, evidence-based and patient-oriented clinical practice of oral immunotherapy in IgE-mediated food allergy

Bégin

Chan

Kim

et al. 2020

Allergy Asthma Clin Immunol

123

118

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Background: Oral immunotherapy (OIT) is an emerging approach to the treatment of patients with IgE-mediated food allergy and is in the process of transitioning to clinical practice.Objective: To develop patient-oriented clinical practice guidelines on oral immunotherapy based on evidence and ethical imperatives for the provision of safe and efficient food allergy management. Materials and methods:Recommendations were developed using a reflective patient-centered multicriteria approach including 22 criteria organized in five dimensions (clinical, populational, economic, organizational and sociopolitical). Data was obtained from: (1) a review of scientific and ethic literature; (2) consultations of allergists, other healthcare professionals (pediatricians, family physicians, nurses, registered dieticians, psychologists, peer supporters), patients and caregivers; and patient associations through structured consultative panels, interviews and on-line questionnaire; and (3) organizational and economic data from the milieu of care. All data was synthesized by criteria in a multicriteria deliberative guide that served as a platform for structured discussion and development of recommendations for each dimension, based on evidence, ethical imperatives and other considerations. Results:The deliberative grid included 162 articles from the literature and media reviews and data from consultations involving 85 individuals. Thirty-eight (38) recommendations were made for the practice of oral immunotherapy for the treatment of IgE mediated food allergy, based on evidence and a diversity of ethical imperatives. All recommendations were aimed at fostering a context conducive to achieving objectives identified by patients and caregivers with food allergy. Notably, specific recommendations were developed to promote a culture of shared responsibility between patients and healthcare system, equity in access, patient empowerment, shared decision making and personalization of OIT protocols to reflect patients' needs. It also provides recommendations to optimize organization of care to generate capacity to meet demand according to patient choice, e.g. OIT or avoidance. These recommendations were made acknowledging the necessity of ensuring sustainability of the clinical offer in light of various economic considerations. © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article' s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article'A multidisciplinary team comprised of experts from a diversity of fields was assembled, including allergists and other healthcare professional...

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“…However, some children have persistent egg allergy (Savage, Matsui, Skripak, & Wood, 2007), which could be life threatening (Macdougall, Cant, & Colver, 2002). To date, no effective method has been developed to manage egg allergy, and the best way for egg‐allergic people is to avoid eggs and egg‐containing foods strictly (Romantsik, Tosca, Zappettini, & Calevo, 2018). …”

Section: Introductionmentioning

confidence: 99%

Influence of heat treatment and egg matrix on the physicochemical and allergenic properties of egg custard

Tong

Xiong

Gao

et al. 2020

Journal of Food Science

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To investigate the influence of heat treatment and egg matrix on egg custard (EC) proteins, 12 different kinds of ECs with different egg/water ratios (1:1, 1:1.5, 1:2, or 1:3, v/v) and different heating temperatures (80, 90, or 100 °C) and times (10, 15, or 20 min) were prepared and evaluated for the digestibility, structure, eliciting capacity and sensitizing capacity using SDS‐PAGE, fluorescence spectra, ELISA, and a BALB/c mouse model, respectively. The physicochemical properties of EC proteins were significantly affected by heat treatment and egg matrix, which showed the increased digestibility and partially unfolded structure. The eliciting capacity of EC evaluated by IgE binding to sera from egg‐allergic patients was reduced after heat treatment, and the EC made by heating at 100 °C for 20 min with a whole egg/water ratio of 1:2 (v/v) was the weakest. The sensitizing capacity of EC was also reduced in the BALB/c mouse model, which showed the significantly decreased levels of specific IgE, IgG, IgG1 and IgG2a, mMCP‐1 and histamine in the mouse sera, as well as cytokine secretions of IL‐4, IL‐5, and IL‐13, compared with the raw egg (RE) group. Results demonstrate that heat treatment and egg matrix significantly reduced the eliciting and sensitizing capacity of EC by changing the tertiary structure and increasing the digestibility of EC proteins. Practical Application Egg custard (EC) is one kind of savory food suitable for all ages, and is also a traditional supplementary food for infants and young children in China. However, limited information is available on the allergenicity of egg custard. In this work, we evaluated how the structure, digestibility, and allergenic potential of egg allergens in EC were altered by the degree of thermal treatment and egg matrix, and elucidated the links between the physicochemical properties and allergenic potential of EC affected by heat treatment and egg matrix. Our results demonstrate that heat treatment and egg matrix significantly reduced the eliciting and sensitizing capacity of EC by changing the tertiary structure and increasing the digestibility of EC proteins.

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Oral and sublingual immunotherapy for egg allergy

Abstract: Editorial group: Cochrane Tobacco Addiction Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 4, 2018.

Cited by 52 publications

References 48 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

CSACI guidelines for the ethical, evidence-based and patient-oriented clinical practice of oral immunotherapy in IgE-mediated food allergy

Influence of heat treatment and egg matrix on the physicochemical and allergenic properties of egg custard

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