Is oral immunotherapy the cure for food allergies?

Anna Nowak-Wȩgrzyn, Alessandro Fiocchi

Research output: Contribution to journalArticle

Abstract

Purpose of review: To review current evidence on food oral immunotherapy (OIT). Recent findings: Desensitized state, defined as the ingestion of a substantial amount of food in the home diet that protects from severe reactions to accidental exposures, can be achieved by approximately 50-75% of the children treated with OIT. The rate of permanent tolerance is unknown; the longer duration of OIT may result in permanent tolerance. Side effects are common both during the initial dose escalation and during home dosing. Most reactions are mild (oral pruritus, abdominal discomfort, and rashes) and decrease in frequency with the longer duration of OIT. Severe reactions treated with epinephrine have been reported during home dosing. Factors associated with increased risk of reactions to previously tolerated doses during home dosing include exercise, viral infection, dosing on empty stomach, menses, and asthma exacerbation. Summary: These preliminary data on OIT are encouraging. Additional studies must answer multiple questions including optimal dose, ideal duration of oral/sublingual immunotherapy, degree of protection, efficacy for different ages, severity and type of food allergy responsive to treatment and need for patient protection during home administration. Until these questions are answered in rigorous multicenter randomized and placebo-controlled trials, OIT remains an experimental approach with not sufficiently well established risk-to-benefit ratio.

Original languageEnglish
Pages (from-to)214-219
Number of pages6
JournalCurrent Opinion in Allergy and Clinical Immunology
Volume10
Issue number3
DOIs
Publication statusPublished - Jun 2010

Keywords

  • Food allergy
  • Milk immunotherapy
  • Oral desensitization
  • Oral immunotherapy
  • Oral tolerance
  • Peanut allergy
  • Peanut immunotherapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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