Oral immunotherapy for food allergy: A Spanish guideline. Immunotherapy egg and milk Spanish guide (items guide). Part I: Cow milk and egg oral immunotherapy: Introduction, methodology, rationale, current state, indications contraindications and oral immunotherapy build-up phase

Martorell, A.; Alonso, E.; Echeverría, Luis; Escudero, Carmelo; García-Rodríguez, R.; Blasco, Cristina; Bone, J. M.; Borja-Segade, J; Bracamonte, Teresa; Claver, Angela; Corzo, JL; Hoz, B de la; Olmo, R. del; Domínguez, Olga; Fuentes‐Aparicio, Victoria; Guallar, I.; Larramona, H.; Martín-Muñoz, F; Matheu, Víctor; Michavila, A.; Ojeda, I; Ojeda, Pedro; Piquer, M.; Poza, Paloma; Reche, Marta; Río, Pablo Rodríguez del; Rodríguez, María Luisa Sancho; Pérez, Francisco Javier Ruano; Sánchez‐García, Silvia; Terrados, S.; Valdesoiro, Laura; Vazquez‐Ortiz, Marta

doi:10.1016/j.aller.2017.05.001

Cited by 18 publications

(19 citation statements)

References 76 publications

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“…Oral immunotherapy (OIT) for food allergy may in future become a therapeutic option in achieving long-term tolerance (rather than just desensitization) with daily ingestion of the culprit food allergen [ 45 ]. For now, OIT remains a research tool, limited mainly to cow's milk, egg, and peanut allergy even though they have been mentioned in recently written clinical practice guidelines from Spain [ 46 ] and Japan [ 47 ]. More well designed randomized clinical trials are needed before OIT can become standard of care (like VIT).…”

Section: Discussionmentioning

confidence: 99%

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Thong

Arulanandam

Tan

et al. 2018

Asia Pacific Allergy

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BackgroundAll Singaporean males undergo medical screening prior to compulsory military service. A history of possible food allergy may require referral to a specialist Allergy clinic to ensure that special dietary needs can be taken into account during field training and deployment.ObjectiveTo study the pattern of food allergy among pre-enlistees who were referred to a specialist allergy clinic to work up suspected food allergy.MethodsRetrospective study of all pre-enlistees registered in the Clinical Immunology/Allergy New Case Registry referred to the Allergy Clinic from 1 August 2015 to 31 May 2016 for suspected food allergy.ResultsOne hundred twenty pre-enlistees reporting food allergy symptoms other than rash alone were referred to the Allergy Clinic during the study period. Of these, 77 (64.2%) had food allergy. Among those with food allergy, mean age was 19.1 ± 1.5 years. They comprised predominantly Chinese (66.2%) and Malays (20.8%). The most commonly reported foods were shellfish/crustaceans (78%), peanut (15.6%), and egg (6.5%). Self-limiting oral allergy syndrome, OAS (itchy lips and throat with/without lip angioedema) was the most common manifestation (n = 33, 42.9%) followed by anaphylaxis (n = 23, 29.9%). Majority of OAS was from shellfish/crustacean (90.6%); of which shrimp (30.3%), crab (15.2%), and lobster (3.0%) were the most common. Mild childhood asthma (69.7%), allergic rhinitis (6.3%), and eczema (6.1%) were the most common atopic conditions among individuals with shellfish/crustacean OAS. This pattern was similar for shellfish/crustacean anaphylaxis. Skin prick tests were most commonly positive for shrimp (OAS 87.1% vs. anaphylaxis 100%), crab (OAS 95.8% vs. 90.9%), and lobster (OAS 91.7% vs. 63.6%).ConclusionOAS to shellfish/crustaceans was more common than anaphylaxis among this study population of young males referred for food allergy symptoms other than rash alone.

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Section: Discussionmentioning

confidence: 99%

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Thong

Arulanandam

Tan

et al. 2018

Asia Pacific Allergy

View full text Add to dashboard Cite

show abstract

“…Thus, the pattern of cytokines in peripheral blood does not seem to differ between these populations, with the result that its determination at the beginning of OIT cannot predict the need for more cautious administration in specific patients. Other analytical parameters, such as specific IgE values, wheal diameter, and basophil activation can predict which patients have a greater risk of developing anaphylaxis during OIT [4,5,8].…”

Section: Resultsmentioning

confidence: 99%

“…This reversal of the predominance of the T H 2 response is observed indirectly as a decrease in specific IgE values [6,8], a decrease in the results of skin tests with the allergens used in immunotherapy [3,4,8], and an increase in specific IgG4 values [7]. Changes in the specific immune response to allergens should be mediated through a change in the cytokine profile, so that there is a decrease in T H 2 cytokines (IL-4, IL-6, and IL-10) in favor of a predominance of T H 1-dependent cytokines (IL-2, TNF, and IFNγ).…”

Section: Discussionmentioning

confidence: 99%

“…OIT with egg consisted of the administration of incremental doses of dehydrated egg whites (OVO DES NM, Nutrición Médica) in 9 steps or milk according to the protocol of SEICAP [4,5]. The egg could be administered in water or orange juice.…”

Section: In Vivo Testsmentioning

confidence: 99%

“…By gradually introducing increasing amounts of the culprit foods into the diet [4,5], children tolerate the intake of usual amounts of these foods. This normalization of intake also reduces the risk of anaphylaxis.…”

Section: Introductionmentioning

confidence: 99%

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Oral Immunotherapy With Egg and Milk: Changes in Peripheral Serum Cytokines Are Not Predictive Factors for Severe Adverse Reactions or for the Final Report

García-Lirio¹,

Díaz²,

Hermosa³

et al. 2018

J Investig Allergol Clin Immunol

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Introduction: Oral immunotherapy (OIT) is a new approach in patients with food allergy. Various immunological mechanisms underlie the reversal of food allergy. In this paper, we study possible changes in peripheral cytokine patterns during OIT. Methods: Determinations of cytokines in peripheral blood were made in children who had milk or egg allergy and who received OIT. The determinations were made before and after OIT, and again following a final repeat oral challenge a month after a diet excluding the culprit food. Results: No significant changes were registered in the cytokines studied (IL-2, IL-4, IL-6, IL-10, IL-12, IL-17, IFNγ, and TNF) at any of the 3 time points. Similarly, no differences in cytokine pattern were observed between children who had presented anaphylaxis during OIT and those who overcame or did not overcome the final oral challenge. Discussion: Peripheral cytokines do not undergo significant changes during the OIT process. They are not predictors of serious adverse reactions or the final result of the OIT.

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Successful oral desensitization in children with cow's milk anaphylaxis: Clinical and laboratory evaluation up to nine-years follow-up

Alves‐Correia

Gáspár

Borrego³

et al. 2019

Allergologia et Immunopathologia

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Oral immunotherapy for food allergy: A Spanish guideline. Immunotherapy egg and milk Spanish guide (items guide). Part I: Cow milk and egg oral immunotherapy: Introduction, methodology, rationale, current state, indications contraindications and oral immunotherapy build-up phase

Abstract: A clinical practice guide is presented for the management of OIT with milk and egg, based on the opinion consensus of Spanish experts.

Cited by 18 publications

References 76 publications

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

Oral Immunotherapy With Egg and Milk: Changes in Peripheral Serum Cytokines Are Not Predictive Factors for Severe Adverse Reactions or for the Final Report

Successful oral desensitization in children with cow's milk anaphylaxis: Clinical and laboratory evaluation up to nine-years follow-up

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