Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?

Eleonora Nucera, Anna Giulia Ricci, Angela Rizzi, Simona Mezzacappa, Alessia Di Rienzo, Valentina Pecora, Giampiero Patriarca, Alessandro Buonomo, Arianna Aruanno, Domenico Schiavino

Research output: Contribution to journalArticle

Abstract

Introduction: The first therapeutic choice for food allergy is avoidance of the responsible food, but when this approach is not possible, specific oral desensitization could be considered as a good alternative. It is not clear yet whether the acquired tolerance is transient or persistent. Aim: We report on a subset of 13 patients of a larger study, treated successfully with specific oral tolerance induction who experienced secondary loss of tolerance after a period of allergen avoidance. Material and methods: Thirteen patients affected by IgE-mediated food allergy: to cow milk (3 patients), to hen egg (3 patients), to cod fish (2 patients), to peanuts (1 patient) and to corn (1 patient) confirmed by a complete allergological workup and a double-blind placebo-controlled food challenge (DBPCFC), were treated with sublingual-oral desensitization. After the interruption of the maintenance phase, the laboratory tests were performed and 12 of 13 patients underwent DBPCFC. Results: Oral specific desensitization was completed successfully in all the 13 reported patients. At different times after the end of treatment, they decided, on their own initiative, to stop the ingestion of incriminated food. A new food allergen re-exposure caused adverse reactions in 12 of 13 patients. The detection of specific IgE and IgG4 during the period of allergen avoidance showed an increase in or a stable level of specific IgE and a decrease in specific IgG4 in 8 patients. Conclusions: According to our experience, the tolerance obtained through the desensitizing treatment is transient and so the regular allergen intake is necessary for its maintenance.

Original languageEnglish
Pages (from-to)392-396
Number of pages5
JournalPostepy Dermatologii I Alergologii
Volume35
Issue number4
DOIs
Publication statusPublished - Aug 1 2018

Keywords

  • Allergen avoidance
  • Follow-up
  • Food allergy
  • Loss of tolerance
  • Maintenance phase
  • Oral specific desensitization

ASJC Scopus subject areas

  • Immunology and Allergy
  • Dermatology

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  • Cite this

    Nucera, E., Ricci, A. G., Rizzi, A., Mezzacappa, S., Di Rienzo, A., Pecora, V., Patriarca, G., Buonomo, A., Aruanno, A., & Schiavino, D. (2018). Specific oral immunotherapy in food allergic patients: transient or persistent tolerance? Postepy Dermatologii I Alergologii, 35(4), 392-396. https://doi.org/10.5114/ada.2018.77671