Oral Rush Desensitization in Peanut Allergy: A Case Report

Patriarca, Giampiero; Nucera, Eleonora; Pollastrini, Emanuela; Pasquale, Tiziana Maria De; Lombardo, Carla; Buonomo, Alessandro; Roncallo, Chiara; Pecora, Valentina; Musumeci, Sonia Nunzialfina; Altomonte, Giorgia; Alonzi, Cristiana; Schiavino, Domenico; Gasbarrini, Giovanni

doi:10.1007/s10620-006-3157-4

Cited by 59 publications

(30 citation statements)

References 17 publications

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“…Following 2 case reports of successful peanut OIT in 2006 [16,17], the first open-label trial of peanut OIT was published in 2009 in a prospective cohort study [18,19], which showed successful desensitization and an overall reassuring safety profile, as well as immunologic changes consistent with those seen in other forms of immunotherapy. With a maintenance dose of 1800 mg of peanut protein, 93% of the 29 patients who completed the protocol were able to tolerate an oral challenge with a cumulative dose of 3.9 g of peanut protein at 36 months [18].…”

Section: Peanut 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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Section: Peanut Oitmentioning

confidence: 99%

Oral Immunotherapy for Food Allergy

Wood

2017

J Investig Allergol Clin Immunol

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“…After early case reports of successful peanut OIT [28,29] , several peanut OIT trials showed a significant increase in the threshold of reactivity after OIT [30][31][32][33][34] . Studies on egg OIT also generally showed positive results [35][36][37] .…”

Section: Oral Immunotherapymentioning

confidence: 99%

Oral and Sublingual Immunotherapy: Potential Causes for Eosinophilic Gastrointestinal Disorders?

Babaie

Mesdaghi

Nishino

et al. 2017

Int Arch Allergy Immunol

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Food allergy is a common health problem worldwide, with increasing prevalence during recent decades. The only approved treatments for food allergy are food avoidance and administration of emergency medications in case of accidental exposure, which negatively affects patients' quality of life, so new treatments are highly desirable. Different food immunotherapy modalities have recently been used, with variable success rates in the induction of desensitization and tolerance, and different numbers and types of adverse reactions. Adverse reactions, especially intolerable gastrointestinal symptoms, are the most important causes of immunotherapy withdrawal. Eosinophilic esophagitis has been reported as a complication of milk, egg, and peanut oral immunotherapies and sublingual immunotherapy for respiratory allergies, but not for food allergies. Eosinophilic gastritis and eosinophilic colitis also rarely happened following egg and milk oral immunotherapies. The patients undergoing oral and sublingual immunotherapies should be closely followed up for a long time, and those with gastrointestinal symptoms should be evaluated by endoscopy of the gastrointestinal tract. These complications are usually reversible after early diagnosis and stopping the immunotherapy protocol.

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“…Desensitization to foods via the subcutaneous route fell out of favor when a clinical trial with injection peanut immunotherapy reported unacceptably high rates of anaphylaxis [6] . In 2006, a successful desensitization to peanut using OIT was reported in 2 cases [7,8] . The first clinical trial of peanut OIT, published in 2009, showed that OIT could be successfully used to induce desensitization in peanut-allergic patients with a favorable side-effect profile and low rates of anaphylaxis [9] .…”

Section: Historical Perspectivementioning

confidence: 99%

Oral Immunotherapy for Food Allergies

Feuille

Nowak‐Węgrzyn²

2016

Ann Nutr Metab

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Oral immunotherapy (OIT) is a promising investigational therapy for food allergy. Clinical trials in peanut, milk, egg, and wheat allergy provide evidence that OIT can effectively desensitize a majority of individuals to a food allergen. While a portion of subjects demonstrate sustained unresponsiveness, the majority regain sensitivity with allergen avoidance. The safety and tolerability of OIT continue to limit its use in some patients. Virtually all studies report adverse reactions that are more frequent during dose escalation but may also occur during maintenance therapy. Recent studies have identified adjunctive therapies (such as omalizumab) which may mitigate adverse effects. There is a paucity of data on the long-term safety and efficacy of OIT. Further study is required before OIT is ready for routine clinical practice. This review is intended to provide the reader with an up-to-date understanding of OIT, including its mechanisms, efficacy, safety profile, and potential utility in clinical practice.

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Oral Rush Desensitization in Peanut Allergy: A Case Report

Cited by 59 publications

References 17 publications

Oral Immunotherapy for Food Allergy

Oral Immunotherapy for Food Allergy

Oral and Sublingual Immunotherapy: Potential Causes for Eosinophilic Gastrointestinal Disorders?

Oral Immunotherapy for Food Allergies

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