Oral immunotherapy for cow's milk allergy with a weekly up-dosing regimen: a randomized single-blind controlled study

Pajno, Giovanni Battista; Caminiti, Lucia; Ruggeri, Paolo; Luca, Raffaele De; Vita, Daniela De; Rosa, Mario La; Passalacqua, Giovanni

doi:10.1016/j.anai.2010.03.015

Cited by 179 publications

(236 citation statements)

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“…Similarly, in food allergies treated with OIT protocols for milk, egg, and peanut, decreases in the serum levels of sIgE, SPTs, BATs and increase of allergen-specific IgG4 after 3-6 months of treatment have been reported (Table 2). However, in two OIT protocols for milk allergy no differences were observed in the serum levels of sIgE (Pajno et al 2010;Skripak et al 2008) (Table 2). Specifically, in the study of Skripak et al (2008) twenty children were studied in a double blind and placebo assay, with a success rate of 92 % upon OIT to milk in the active group (13 patients).…”

Section: Mechanisms Of Oit In Food Allergymentioning

confidence: 95%

“…Specifically, in the study of Skripak et al (2008) twenty children were studied in a double blind and placebo assay, with a success rate of 92 % upon OIT to milk in the active group (13 patients). Equally, Pajno et al (2010) carried out a double blind and placebocontrolled trial for OIT to milk, in 30 children obtained a 76 % of tolerance upon OFC in the active group (15 patients). Moreover, in both studies, an increase in the serum levels of sIgG4 to milk was observed in the group of active patients (Table 2).…”

Section: Mechanisms Of Oit In Food Allergymentioning

confidence: 99%

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Food Allergy and the Oral Immunotherapy Approach

Cabrera

Urra

2014

Arch. Immunol. Ther. Exp.

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Food allergy represents an increasing health problem, with children being the most affected population. The symptoms can appear within minutes or hours of ingesting the offending food, producing skin manifestations, respiratory, gastrointestinal and anaphylactic reactions in the severe forms. Food allergy is established by the loss of tolerance to food proteins, and is characterized by an altered balance of regulatory T (Treg) cells and the shift to Th2 type cytokines in the intestinal lamina propria. We have described the contribution of different factors in establishing oral tolerance, such as the antigenic exposition route, the gut microenvironment, and the timing of the food introduction. Apart from avoiding the food, immunotherapy is the only intervention which produces oral desensitization to food proteins. Among the underlying immunological mechanisms of oral immunotherapy (OIT) are the changes in humoral immunity (a decrease of allergen-specific IgE and an increase of allergen-specific IgG4) and cellular changes such as the increased number of FoxP3 ? Treg cells. At present, the experiences of OIT with various foods are offering promising results. OIT appears to be safe producing low adverse reactions, and effective in inducing desensitization in most subjects with food allergy.

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Section: Mechanisms Of Oit In Food Allergymentioning

confidence: 95%

Section: Mechanisms Of Oit In Food Allergymentioning

confidence: 99%

Food Allergy and the Oral Immunotherapy Approach

Cabrera

Urra

2014

Arch. Immunol. Ther. Exp.

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“…Other studies of milk OIT included those of Pajno et al [44] in 2010, as well as a study from the same group in 2013 suggesting that maintenance dosing after desensitization is equally successful daily or twice weekly [45]. In 2011, Martorell et al [46] completed an RCT of 60 children aged 24 to 36 months and demonstrated desensitization in 90% at 1 year.…”

Section: Milk Oitmentioning

confidence: 99%

“…For example, in a study of milk OIT in young children, 47% developed moderate reactions over the course of treatment [46]. More severe reactions requiring treatment with epinephrine and ß-agonists are most common during dose escalation but can also occur during maintenance therapy [24,41,42,44,46]. Wasserman et al [62] reported that 95 reactions requiring epinephrine occurred during peanut OIT in 352 patients.…”

Section: Immunologic Changes With Oitmentioning

confidence: 99%

Oral Immunotherapy for Food Allergy

Wood

2017

J Investig Allergol Clin Immunol

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Food allergy is a potentially life-threatening condition with no approved therapies apart from avoidance and injectable epinephrine for treatment of acute allergic reactions. Oral immunotherapy (OIT) is an experimental treatment in which patients consume gradually increasing quantities of the food to which they are allergic in an attempt to induce some level of desensitization. While desensitization is possible in most patients, OIT carries significant risks for allergic reactions, and the ability to induce longer-term tolerance has not yet been established. This review focuses on selected studies of OIT for the treatment of common food allergies such as cow's milk, hen's egg, and peanut. Key words: Food allergy. Oral immunotherapy. Cow's milk. Hen's egg. Peanut. Desensitization. Tolerance. Sustained unresponsiveness. Skin prick test (SPT). Immunoglobulin E (IgE). Omalizumab. ResumenLa alergia alimentaria es una condición potencialmente mortal para la que no existen tratamientos aprobados, excepto la evitación y la epinefrina para tratar reacciones alérgicas graves. La inmunoterapia oral (OIT) es un tratamiento experimental en el cual los pacientes ingieren cantidades gradualmente crecientes del alimento al que son alérgicos, con el fin de inducir algún nivel de desensibilización. Si bien la desensibilización es posible en la mayoría de los pacientes, OIT conlleva riesgos importantes de reacciones alérgicas y la capacidad de inducir tolerancia a más largo plazo todavía no ha sido establecida. Este artículo de revisión se centra en una selección de estudios de OIT para el tratamiento de alergias a alimentos comunes, como son la leche de vaca, huevos de gallina y cacahuete. Palabras clave: Alergia alimentaria. Inmunoterapia oral. Leche de vaca. Huevo de gallina. Cacahuete. Desensibilización. Tolerancia. Falta de respuesta sostenida. Prick test. Inmunoglobulina. Omalizumab.

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“…A weekly up-dosing regimen [18], a slow updosing method [19], rapid oral desensitization in combination with omalizumab therapy [20], different maintenance feeding regimens [21], and baked milk OIT [22] are some of the strategies adopted to improve the efficacy of OIT in patients with CMA.…”

Section: Induction Of Tolerancementioning

confidence: 99%