Oral Immunotherapy for Egg Allergy: A Double-Blind Placebo-Controlled Study, with Postdesensitization Follow-Up

Caminiti, Lucia; Pajno, Giovanni Battista; Crisafulli, Giuseppe; Chiera, Fernanda; Collura, Mirella; Panasci, Girolamo; Ruggeri, Paolo; Guglielmo, Francesco; Passalacqua, Giovanni

doi:10.1016/j.jaip.2015.01.017

Cited by 105 publications

(164 citation statements)

References 29 publications

Supporting

Mentioning

151

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, IgG4 has been reported to be involved in tolerance induction [4,5]. In the present study, the egg white-specific IgG4 levels were found to be significantly higher than the baseline levels at all time points, indicating that an immunological change was induced.…”

Section: Discussionsupporting

confidence: 44%

“…A high efficacy of desensitization in response to oral immunotherapy (OIT) has been reported [4]; however, unresponsiveness and tolerance are not easily achieved, and moderate to severe symptoms sometimes occur [4,5,6]. Therefore, long-term treatment methods with a higher level of safety are desired [6].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, long-term treatment methods with a higher level of safety are desired [6]. Currently, the most commonly used target dose for OIT against hen's egg allergy is 1 whole egg [4,5,7]. Although Bravin and Luyt [8] reported their experience using baked egg as an oral tolerance food with a target dose of 6,250 mg of egg protein, few studies on low-target volume immunotherapy for egg allergy have been reported [9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Safety and Efficacy of Low-Dose Oral Immunotherapy for Hen's Egg Allergy in Children

Yanagida¹,

Sato

Asaumi³

et al. 2016

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Background: The minimal dose for oral immunotherapy (OIT) tolerance is unknown. We investigated the efficacy and safety of low-dose OIT with 1/32 of the volume of a whole egg. Methods: Thirty-three children (aged ≥5 years) with egg allergies confirmed by oral food challenge against 1/32 of a heated whole egg (194 mg of egg protein) were enrolled. The OIT group ingested a scrambled egg once a day. The volume was gradually increased up to a maximum of 1/32 of a heated whole egg. Egg consumption was completely absent in the control group. Results: There were no significant differences in background between the OIT and control groups. Respectively, 71% (15/21) and 0% (0/12) of the patients in the OIT and control groups exhibited sustained unresponsiveness to 1/32 of a whole egg 2 weeks after stopping OIT after 12 months (p < 0.001); 33% (7/21) and 0% (0/12; p = 0.032), respectively, showed sustained unresponsiveness to 1/2 of a whole egg. Egg white- or ovomucoid-specific IgE levels in the OIT group were significantly lower than at baseline after 12 months. Egg white- or ovomucoid-specific IgG as well as IgG4 levels in the OIT group were significantly higher than baseline levels after 1, 3, 6, and 12 months. Adverse allergic reactions were rare, and most symptoms were mild. Conclusions: Low-dose OIT induced sustained unresponsiveness to 1/32 and 1/2 of a whole egg, with no severe symptoms. To improve food allergies, continuous intake of small amounts of these foods may be as effective as the consumption of larger quantities.

show abstract

Section: Discussionsupporting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and Efficacy of Low-Dose Oral Immunotherapy for Hen's Egg Allergy in Children

Yanagida¹,

Sato

Asaumi³

et al. 2016

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…Moreover, the amount of EW powder is approximately equivalent of one third of an egg per day (100 g of raw EW contains 10.5 g of protein, and the percentage of raw EW in an egg is approximately 70%) [18]. In the human OIT studies, the maximum administration of EW powder for OIT was 2 g per day [19] and 4 g per day [20]. The main advantage of OIT based on an allergen-supplemented diet is that the daily amount of allergen protein can be divided into 3 meals.…”

Section: Discussionmentioning

confidence: 99%

“…Allergen-specific IgG4 could inhibit allergen-specific IgE binding to B cells [23, 30], and increased when oral desensitization was induced [4, 6, 20]. However, the IgG subclasses in the mouse are IgG1, IgG2a, IgG2b, and IgG3, and IgG1 in the mouse is equivalent to IgG4 in humans [16].…”

Section: Discussionmentioning

confidence: 99%

Diets Supplemented with 1% Egg White Induce Oral Desensitization and Immune Tolerance in an Egg White-Specific Allergic Mouse Model

Maeta¹,

Marin²,

Katahira³

et al. 2018

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Background: The objective of this study was to determine the required concentration of egg white (EW) in the diet to induce oral desensitization and/or immune tolerance within 4 weeks of oral immunotherapy (OIT) in an EW allergic mouse model. Methods: Female BALB/c mice were systemically sensitized to EW by intraperitoneal injections and subsequently subjected to oral allergen gavage. Sensitized mice were provided 4 weeks of OIT by supplementing with 0 (non-OIT), 0.01, 0.1, or 1% EW in a 20% casein diet. Nonsensitized mice served as the nonallergy group. We performed oral and intraperitoneal EW challenges, assessed vascular permeability in the dorsal skin, and measured allergic biomarkers. Results: The change in rectal temperature after oral challenge was not significantly different between the nonallergy and 1% EW groups, and the frequency of diarrhea in the 1% EW group was lower than that in the non-OIT group. The levels of plasma ovomucoid-specific IgE, IgA, and IgG2a in the 1% EW group at the study endpoint were significantly lower than those in the non-OIT group. IFN-γ and IL-10 secretions of spleen lymphocytes in the 1% EW group were significantly higher than those in the non-OIT group, and the percentage of CD4+Foxp3+ cells in the 1% EW group was higher than that in the non-OIT group. Conclusion: These results suggested that diet supplemented with 1% EW can induce oral desensitization and immune tolerance in the EW allergic mouse model.

show abstract

Effect of Maternal Egg Intake During the Early Neonatal Period and Risk of Infant Egg Allergy at 12 Months Among Breastfeeding Mothers

et al. 2023

View full text Add to dashboard Cite

ImportanceEgg introduction in infants at age 4 to 6 months is associated with a lower risk of immunoglobulin E–mediated egg allergy (EA). However, whether their risk of EA at age 12 months is affected by maternal intake of eggs at birth is unknown.ObjectiveTo determine the effect of maternal egg intake during the early neonatal period (0-5 days) on the development of EA in breastfed infants at age 12 months.Design, Setting, and ParticipantsThis multicenter, single-blind (outcome data evaluators), randomized clinical trial was conducted from December 18, 2017, to May 31, 2021, at 10 medical facilities in Japan. Newborns with at least 1 of 2 parents having an allergic disease were included. Neonates whose mothers had EA or were unable to consume breast milk after the age of 2 days were excluded. Data were analyzed on an intention-to-treat basis.InterventionsNewborns were randomized (1:1) to a maternal egg consumption (MEC) group, wherein the mothers consumed 1 whole egg per day during the first 5 days of the neonate’s life, and a maternal egg elimination (MEE) group, wherein the mothers eliminated eggs from their diet during the same period.Main Outcomes and MeasuresThe primary outcome was EA at age 12 months. Egg allergy was defined as sensitization to egg white or ovomucoid plus a positive test result in an oral food challenge or an episode of obvious immediate symptoms after egg ingestion.ResultsOf the 380 newborns included (198 [52.1%] female), 367 (MEC: n = 183; MEE: n = 184) were followed up for 12 months. On days 3 and 4 after delivery, the proportions of neonates with ovalbumin and ovomucoid detection in breast milk were higher in the MEC group than in the MEE group (ovalbumin: 10.7% vs 2.0%; risk ratio [RR], 5.23; 95% CI, 1.56-17.56; ovomucoid: 11.3% vs 2.0%; RR, 5.55; 95% CI, 1.66-18.55). At age 12 months, the MEC and MEE groups did not differ significantly in EA (9.3% vs 7.6%; RR, 1.22; 95% CI, 0.62-2.40) or sensitization to egg white (62.8% vs 58.7%; RR, 1.07; 95% CI, 0.91-1.26). No adverse effects were reported.Conclusions and RelevanceIn this randomized clinical trial, EA development and sensitization to eggs were unaffected by MEC during the early neonatal period.Trial RegistrationUMIN Clinical Trials Registry: UMIN000027593

show abstract

Oral Immunotherapy for Egg Allergy: A Double-Blind Placebo-Controlled Study, with Postdesensitization Follow-Up

Cited by 105 publications

References 29 publications

Safety and Efficacy of Low-Dose Oral Immunotherapy for Hen's Egg Allergy in Children

Safety and Efficacy of Low-Dose Oral Immunotherapy for Hen's Egg Allergy in Children

Diets Supplemented with 1% Egg White Induce Oral Desensitization and Immune Tolerance in an Egg White-Specific Allergic Mouse Model

Effect of Maternal Egg Intake During the Early Neonatal Period and Risk of Infant Egg Allergy at 12 Months Among Breastfeeding Mothers

Contact Info

Product

Resources

About