Safety and predictors of adverse events during oral immunotherapy for milk allergy: severity of reaction at oral challenge, specific IgE and prick test

Vazquez‐Ortiz, Marta; Alvaro‐Lozano, Montserrat; Alsina, Laia; García-Paba, M B; Piquer-Gibert, M.; Giner-Muñoz, M.T.; Lozano, J.J.; Dominguez-Sanchez, O.; Jiménez, Rosa M.; Dias, Marcia Tosta; Martín-Mateos, María Anunciación; Plaza-Martin, Ana María

doi:10.1111/cea.12012

Cited by 115 publications

(95 citation statements)

References 37 publications

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“…Such omalizumab-enhanced OIT results are remarkable, given that in both studies the up-dosing phase was completed in a median time of 8 weeks and because both studies specifically included patients with high food-specific IgE levels, which normally correlate with desensitization failure [12][13][14]. A third study of omalizumab and OIT recently confirmed the usefulness of omalizumab in facilitating oral desensitization in milkallergic patients.…”

Section: Targeting Igementioning

confidence: 93%

“…It is estimated that >90% of patients undergoing oral desensitization develop reactions, and because of frequent allergic reactions, desensitization must be prolonged (1-2 years) before efficacious maintenance dosing can be achieved. In informahealthcare.comaddition, 10-30% of patients, generally those with higher initial food-specific IgE levels, have repeated reactions and are thus refractory to OIT [12][13][14]. Indeed, recent meta-analyses of oral desensitization studies suggest that the frequent serious adverse reactions might outweigh the benefits of OIT [15,16].…”

Section: Novel Therapiesmentioning

confidence: 99%

See 1 more Smart Citation

Targeting IgE to facilitate oral immunotherapy for food allergy: a potential new role for anti-IgE therapy?

Umetsu¹

2014

Expert Review of Clinical Immunology

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Section: Targeting Igementioning

confidence: 93%

Section: Novel Therapiesmentioning

confidence: 99%

Targeting IgE to facilitate oral immunotherapy for food allergy: a potential new role for anti-IgE therapy?

Umetsu¹

2014

Expert Review of Clinical Immunology

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“…A pesar de los buenos resultados reportados en la mayoría de los pacientes (30,31), la tasa de abandono en el primer año ronda entre 10 y 40 % de los pacientes debido a síntomas usualmente leves o moderados, aunque también ocurren en ocasiones reacciones anafilácticas (32,33), por lo que dicha inducción debe hacerse bajo estricta vigilancia médica especializada. Debido a que actualmente no existen criterios aceptados de manera unánime sobre qué pacientes pueden recibir esta terapia, nosotros proponemos los criterios del cuadro 3 basándonos en nuestra experiencia y en la literatura actual disponible.…”

Section: Manejounclassified

Alergia a la leche y al huevo: diagnóstico, manejo e implicaciones en América Latina

Sánchez¹,

Restrepo

Mopan

et al. 2013

biomedica

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La sensibilización a alimentos y el desarrollo de alergias alimentarias viene aumentando en todo el mundo, siendo la leche de vaca y el huevo de gallina los principales alimentos implicados. En la mayoría de los países latinoamericanos no existen guías de manejo y cuando se elaboren deberán adaptarse a las condiciones de la población de cada región. En el presente artículo presentamos una revisión del manejo de la alergia alimentaria a la leche y al huevo útil para el personal de salud de todos los niveles, así como algunas consideraciones de los factores presentes en los países latinoamericanos.Palabras clave: alergia e inmunología, hipersensibilidad al huevo, hipersensibilidad a la leche, alimentos, anafilaxia, dieta, desensibilización inmunológica, inmunoterapia, tolerancia. doi: http://dx.doi.org/10.7705/biomedica.v34i1.1677 Milk and egg allergy: Diagnosis, management and implications for Latin AmericaSensitization to food allergens, as well as the development of food allergies, is increasing worldwide, and cow's milk and hen's eggs are the main implicated foods. In most Latin American countries there are no management guidelines on the aforementioned topics; at their creation, such guidelines should be adapted to the conditions of the population in each region. This paper presents a review of the management of food allergy to milk and eggs useful for health personnel at all levels and some considerations of the factors found in Latin American developing countries.Keywords: Allergy and immunology, egg hypersensitivity, milk hypersensitivity, food, anaphylaxis, diet; desensitization, immunologic; immunotherapy, permissiveness. doi: http://dx.doi.org/10. 7705/biomedica.v34i1.1677 Las reacciones adversas a los alimentos se producen por una gran variedad de mecanismos que incluyen el sistema inmunitario, los procesos enzimáticos, las reacciones fisiológicas y los componentes psicológicos (1). Cuando se demuestra un mecanismo inmune, se le denomina alergia a alimentos, y si se encuentran niveles elevados de inmunoglobulina E (IgE) específica para alérgenos de alimentos con relevancia clínica, se habla de alergia alimentaria mediada por IgE (2). Igualmente, se pueden presentar reacciones alérgicas a alimentos mediadas por mecanismos celulares y alergias alimentarias mixtas, en las cuales participan los dos mecanismos anteriores.Los alimentos implicados y la frecuencia de las reacciones dependen de los hábitos y costumbres alimentarias en los distintos países, al igual que de los parámetros metodológicos utilizados en los diferentes estudios. Se estima que la prevalencia de reacciones adversas a alimentos es de entre 13 y 43 %, según informes de los padres de niños preescolares (3,4); sin embargo, solo una parte de las reacciones reportadas en dichos informes se deben realmente a un alimento; en un estudio en el que 28 % de los pacientes había

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“…Além disso, a história clínica do paciente deve ser considerada na interpretação do teste de alergia [11]. A determinação dos alérgenos mais comuns e a relação entre os resultados do TC com as doenças alérgicas em cada área desempenha um papel importante no diagnóstico e tratamento de doenças alérgicas, como no caso da imunoterapia [11,12].…”

Section: Introductionunclassified

Teste cutâneo em doenças alérgicas: uma revisão sistemática

Soldera

Bugança

Santos

et al. 2015

Sci Med

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RESUMOObjetivos: Identificar os principais alérgenos aplicados em testes cutâneos para sensibilização atópica em pacientes com diagnóstico de asma e rinite alérgica. Métodos: Uma revisão sistemática foi realizada para identificar estudos clínicos nos últimos 10 anos, tendo como desfecho a utilização do teste cutâneo (prick test) no diagnóstico de asma e rinite alérgica. Foi realizada uma pesquisa nas bases de dados PubMed, Scielo e ScienceDirect. Foram incluídos artigos que abordam a utilização direta do teste cutâneo no diagnóstico das doenças alérgicas. Além disso, os estudos obrigatoriamente deveriam descrever o protocolo de utilização, bem como os alérgenos aplicados no teste. Para seleção dos artigos, três pesquisadores analisaram de forma independente os critérios de inclusão, sendo os mesmos analisados por mais dois revisores. Resultados: Treze instrumentos foram incluídos na sistemática, tendo uma variação expressiva na quantidade de reagentes (de 3 a 36 tipos). Dos 36, cinco possuíram a maior frequência de positividade à sensibilização (Artemisia vulgaris, Dermatophagoides farinae, Dermatophagoides pteronyssinus, epitélios de cão e de gato). Como parte do protocolo de aplicação, a região do antebraço e o período de 15 a 20 minutos são os mais frequentes. Conclusões: Alérgenos mais comuns em alergia respiratória foram descritos, sendo importante levar em consideração a região e população investigadas.DESCRITORES: testes cutâneos; diagnóstico; asma; rinite. ABSTRACT Aims:To identify the major allergens used in skin tests for atopic sensitization in patients with asthma and allergic rhinitis. Methods: A systematic review was performed to identify clinical studies in the past 10 years whose outcomes included the skin test (prick test) in the diagnosis of asthma and allergic rhinitis. The PubMed, SciELO, and ScienceDirect databases were searched and articles that addressed the direct use of skin testing in the diagnosis of allergic diseases were included. In addition, the studies had to describe the protocol and the allergens used in the test. For selection of the articles, three researchers independently analyzed the inclusion criteria, which were analyzed by two other reviewers. Results: Thirteen instruments were included in the systematic review, and the amount of reagents used varied significantly (between 3 and 36). Of the 36 reagents, five had the highest frequency of positive sensitization (Artemisia vulgaris, Dermatophagoides farinae, Dermatophagoides pteronyssinus, dog and cat epithelia). As part of the application protocol, the forearm and the period of 15-20 minutes are the most frequently used. Conclusions:The most frequently detected allergens were described, and both the region and the studied population are important factors to be considered.

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Safety and predictors of adverse events during oral immunotherapy for milk allergy: severity of reaction at oral challenge, specific IgE and prick test

Abstract: CM-OIT was insufficiently safe in 25% of children. The above-mentioned clinical and immunological parameters would help clinicians to identify highly reactive patients before CM-OIT. In them, individualized schedules and premedication should be considered.

Cited by 115 publications

References 37 publications

Targeting IgE to facilitate oral immunotherapy for food allergy: a potential new role for anti-IgE therapy?

Targeting IgE to facilitate oral immunotherapy for food allergy: a potential new role for anti-IgE therapy?

Alergia a la leche y al huevo: diagnóstico, manejo e implicaciones en América Latina

Teste cutâneo em doenças alérgicas: uma revisão sistemática

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