Oral immunotherapy in children with IgE-mediated hen's egg allergy: Follow-ups at 2.5 and 7 years

Background The present report was a follow-up investigation at 2.5- and 7-year intervals of a previous study of 20 children with moderate-to-severe immunoglobulin E (IgE) mediated hen's egg (HE) allergy who received oral immunotherapy (OIT) with raw HE. The study design of the previous study divided the 20 subjects into two groups of 10 each: (1) group 1, the OIT group (OIT-G), and, (2) group 2, an age-matched control group (C-G). In that study, 8 of 10 of the children in the OIT-G were successfully desensitized, one child was partially desensitized, and desensitization failed in one child. The aims of the present study were to evaluate the long-term effectiveness and safety profile of OIT with raw HE, and to assess the course and prognostic value of skin-prick tests (SPT) and serum-specific HE-IgEs in this study population. Methods Of the 20 children who were recalled, 2 dropped out, which left 18 to be evaluated. Information on their HE intake was recorded, and SPTs with HE allergen extracts and with raw and hard-boiled HE were performed. Ovomucoid- and ovalbumin-specific IgE levels were also measured. Results At the first (2.5-year) and second (7-year) follow-ups, 87.5% of the children in the OIT-G who tolerated raw HE were still tolerant, whereas the children in the C-G were significantly less tolerant. Overall, cutaneous sensitivity to HE significantly decreased after the 6-month desensitization period and at both follow-ups with regard to the OIT-G but not with regard to the C-G. A significant reduction in serum ovomucoid- and ovalbumin-specific IgE levels was seen in both the OIT-G and the C-G. Conclusion Clinical raw HE tolerance induced by OTT persists over time. Negativization of SPTs could be considered a more reliable prognostic indicator of clinical tolerance to raw HE than the reduction in specific-HE IgE levels. Raw-HE OIT would seem to be a promising method to treat HE allergy.

[1]  G. Passalacqua,et al.  Safety profile of oral immunotherapy with cow's milk and hen egg: A 10-year experience in controlled trials. , 2016, Allergy and asthma proceedings.

[2]  A. Henning,et al.  Long-term treatment with egg oral immunotherapy enhances sustained unresponsiveness that persists after cessation of therapy. , 2016, The Journal of allergy and clinical immunology.

[3]  G. Passalacqua,et al.  Oral Immunotherapy for Egg Allergy: A Double-Blind Placebo-Controlled Study, with Postdesensitization Follow-Up. , 2015, The journal of allergy and clinical immunology. In practice.

[4]  J. Savage,et al.  Food allergy: epidemiology and natural history. , 2015, Immunology and allergy clinics of North America.

[5]  Scott H Sicherer,et al.  Food allergy: a practice parameter update-2014. , 2014, The Journal of allergy and clinical immunology.

[6]  A. Hogan,et al.  Baseline Specific IgE levels Are Useful to Predict Safety of Oral Immunotherapy in Egg-Allergic Children , 2014, Pediatrics.

[7]  M. Ben-Shoshan,et al.  Diagnosis and management of food allergies: new and emerging options: a systematic review , 2014, Journal of asthma and allergy.

[8]  R. Wood,et al.  Sublingual (SLIT) Versus Oral Immunotherapy (OIT) for Food Allergy , 2014, Current Allergy and Asthma Reports.

[9]  M. Ebisawa,et al.  Immunotherapy in food allergy: towards new strategies. , 2014, Asian Pacific journal of allergy and immunology.

[10]  H. Karasuyama,et al.  A Molecular Mechanism Underlying Atopic Dermatitis In Hyper-IgE Syndrome , 2014 .

[11]  B. Chipps Oral Immunotherapy for Treatment of Egg Allergy in Children , 2013, Pediatrics.

[12]  P. Meglio Oral food desensitization: the BACH proposal for the very gradual reintroduction of a food , 2013, Current opinion in allergy and clinical immunology.

[13]  D. Stablein,et al.  The natural history of egg allergy in an observational cohort. , 2013, The Journal of allergy and clinical immunology.

[14]  E. Galli,et al.  Oral food desensitization in children with IgE‐mediated hen’s egg allergy: a new protocol with raw hen’s egg , 2013, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[15]  S. Miceli Sopo,et al.  Specific oral tolerance induction with raw hen’s egg in children with very severe egg allergy: A randomized controlled trial , 2013, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[16]  J. M. Urra,et al.  Oral rush desensitization to egg: efficacy and safety , 2011, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[17]  Julie Wang,et al.  Current understanding of egg allergy. , 2011, Pediatric clinics of North America.

[18]  A. Burks,et al.  Individualized IgE-based dosing of egg oral immunotherapy and the development of tolerance. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[19]  Youngshin Han,et al.  The natural history and prognostic factors of egg allergy in Korean infants with atopic dermatitis. , 2009, Asian Pacific journal of allergy and immunology.

[20]  A. Burks,et al.  Adverse reactions during peanut oral immunotherapy home dosing. , 2009, The Journal of allergy and clinical immunology.

[21]  R. Heine,et al.  Egg allergy in childhood: an update , 2009, Current opinion in allergy and clinical immunology.

[22]  R. Wood,et al.  The natural history of egg allergy. , 2007, The Journal of allergy and clinical immunology.

[23]  B. Niggemann,et al.  Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction , 2007, Allergy.

[24]  G. Passalacqua,et al.  Food‐exercise‐induced anaphylaxis in a boy successfully desensitized to cow milk , 2007, Allergy.

[25]  B. Niggemann,et al.  Specific oral tolerance induction with food in children: transient or persistent effect on food allergy? , 2005, Allergy.

[26]  P. Meglio,et al.  A protocol for oral desensitization in children with IgE‐mediated cow's milk allergy , 2004, Allergy.

[27]  J. Díaz-Pena,et al.  Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy. , 2002, The Journal of allergy and clinical immunology.

[28]  A. Høst,et al.  Cow's milk protein allergy and intolerance in infancy Some clinical, epidemiological and immunological aspects , 1994, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[29]  N. Kjellman,et al.  IgE in neonates is not suitable for general allergy risk screening. , 1994, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[30]  R. Ford,et al.  Natural history of egg hypersensitivity. , 1982, Archives of disease in childhood.

[31]  A. Henning,et al.  The natural history of milk allergy in an observational cohort. , 2013, The Journal of allergy and clinical immunology.

[32]  L. Ronfani,et al.  Adverse effects during specific oral tolerance induction: in home phase. , 2012, Allergologia et immunopathologia.

[33]  P. Ojeda,et al.  Home-based oral immunotherapy protocol with pasteurized egg for children allergic to hen's egg. , 2012, The Israel Medical Association journal : IMAJ.

[34]  K. Kurihara,et al.  Rush specific oral tolerance induction in school-age children with severe egg allergy: one year follow up. , 2010, Allergology international : official journal of the Japanese Society of Allergology.

[35]  A. Burks,et al.  Egg oral immunotherapy in non-anaphylactic children with egg allergy: follow-up. , 2008, The Journal of allergy and clinical immunology.

[36]  D. Moneret-vautrin,et al.  Oral desensitization in children with milk and egg allergies obtains recovery in a significant proportion of cases. A randomized study in 60 children with cow's milk allergy and 90 children with egg allergy. , 2007, European annals of allergy and clinical immunology.

[37]  A. Burks,et al.  Egg oral immunotherapy in nonanaphylactic children with egg allergy. , 2007, The Journal of allergy and clinical immunology.

[38]  A. Høst Clinical course of cow's milk protein allergy and intolerance. , 1998, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[39]  M. Blaiss,et al.  Food allergy in childhood. , 1991, Comprehensive therapy.