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

Umetsu, Dale T.

doi:10.1586/1744666x.2014.948849

Cited by 4 publications

(1 citation statement)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among those individuals who achieved the maintenance dose, depending on the respective allergen (peanut vs milk or egg allergy), the percentage of patients that experience desensitization (clinical effects restraint to the duration of OIT) ranges from 42% to 93% (1,(76)(77)(78)(79)(80)(81) and those who experience long-term clinical effects that persist despite OIT discontinuation equivalent to sustained unresponsiveness and possibly tolerance development are ranging from 28% to 50% (1, 2, 75, 76, 82). Consequently, new approaches for peanut, milk, and egg oral immunotherapy with hypoallergenic variants or combined with the anti-IgE antibody omalizumab are under investigation to reduce allergic reactions during dose-up phase and confer a safer oral desensitization (83). Although the body of evidence is increasing and the results are encouraging, these treatment modalities so far did not reach a level of a clinical recommendation (84).…”

Section: Oral and Sublingual Immunotherapy In Food Allergymentioning

confidence: 99%

Markers of tolerance development to food allergens

Ponce

Diesner

Szépfalusi

et al. 2016

Allergy

View full text Add to dashboard Cite

IgE-mediated reactions to food allergens are the most common cause of anaphylaxis in childhood. Although allergies to cow's milk, egg, or soy proteins, in contrast to peanut and tree nut allergens, resolve within the first 6 years of life in up to 60% due to natural tolerance development, this process is not well understood. At present, there is no cure or treatment for food allergy that would result in an induction of tolerance to the symptom-eliciting food. Avoidance, providing an emergency plan and education, is the standard of treatment. Oral immunotherapeutic approaches have been proven reasonable efficacy; however, they are associated with high rates of side-effects and low numbers of patients achieving tolerance. Nevertheless, mechanisms that take place during oral immunotherapy may help to understand tolerance development. On the basis of these therapeutic interventions, events like loss of basophil activation and induction of regulatory lymphocyte subsets and of blocking antibodies have been described. Their functional importance at a clinical level, however, remains to be investigated in detail. Consequently, there is eminent need to understand the process of tolerance development to food allergens and define biomarkers to develop and monitor new treatment strategies for food allergy.IgE-mediated food allergy represents the most important cause of anaphylaxis in childhood. While milk and egg allergy are associated with a high rate of natural tolerance development within the first 6 years of life, this is less clear for other food allergies. Consequently, once it is communicated the diagnosis persists often lifelong severely impacting the quality of life of the patient and the environment despite the recommendation to reconsider clinical tolerance development from time to time.Currently, avoidance, providing an emergency plan and teaching, is the standard of treatment; however, there is no cure or treatment that has reached the level of recommendation to re-induce tolerance to the symptom-eliciting food. Tolerance assessment occurs either via oral food challenges or due to unintended exposure. Given the cost and time intensiveness of oral food challenges and its potential harmfulness, there is eminent need to understand the process of tolerance development and define markers thereof to develop and monitor new treatment strategies for food allergy. This review aimed to provide an overview on recent advances regarding markers and mechanisms of tolerance development to food allergens.Oral tolerance in the context of food allergy is considered to occur if the antigen/food can be ingested without problems despite prolonged periods of avoidance, while the status of desensitization is strictly dependent on regular ingestion of the respective food in order to confer protection from allergic reactions. Currently, there is no general consensus on the exact time frame of avoidance and re-exposure that would allow the usage of the terminus tolerance that is considered equivalent to cure in the context of or...

show abstract