Oral immunotherapy for milk allergy

Proctocolitis in a child treated with oral immunotherapy for cow’s milk allergy

“…Among these methods, OIT is the primary treatment option. Meta-analyses have indicated that OIT increases the tolerable amount of milk for many patients [2]. It has been reported that during the ongoing OIT treatment, severe side effects are very rare, and most are of mild to moderated forms [2].…”

“…The cow's milk allergy regresses spontaneously in the majority of the patients, however due to the absence of this regress in some patients and the possible life-threatening reaction development in case of accidental contact, the new treatment options such as oral immunotherapy (OIT) are being searched. Although the studies reported to be generally well OIT tolerated [2], there also statements available in respect of the delayed reactions formation such as eosinophilic esophagitis in the monitoring [3]. Here, a case where the previously existing proctocolitis is aggravated during OIT and the spontaneously developed tolerance is regressed shall be presented.…”

The slow progress in achieving an effective treatment for food allergy

“…Table 1 summarizes the results of meta-analyses on OIT and SLIT for food allergy. Most meta-analyses addressed immunotherapy for single foods, in particular cow's milk [7][8][9] and peanut [10], while one included immunotherapy for several foods [11]. The first two meta-analyses were affected by imprecision of the estimates [7] and low quality of the evidence for efficacy [8].…”

“…Most meta-analyses addressed immunotherapy for single foods, in particular cow's milk [7][8][9] and peanut [10], while one included immunotherapy for several foods [11]. The first two meta-analyses were affected by imprecision of the estimates [7] and low quality of the evidence for efficacy [8]. The meta-analysis on OIT and SLIT for peanut allergy showed a significantly positive effect in actively treated patients than in controls, but the number of patients was small [10].…”

“…Anyhow, the authors of both these analyses agreed on the need of additional larger, well-designed, and double-blind controlled studies. As far as safety and tolerability are concerned, a high rate of adverse effects was reported by Yeung et al, mostly mild and self-limited, but not infrequently requiring the use of epinephrine [8]. Concerning EPIT, promising data from experimental models, from trials performed with inhalant allergens, and from a pilot trial in children allergic to cow's mil k are available [12].…”