Home-based oral immunotherapy (OIT) with an intermittent loading protocol in children unlikely to outgrow egg allergy

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• 作者：Kyoko Sudo (1)
  Shoichiro Taniuchi (1)
  Masaya Takahashi (1)
  Kazuhiko Soejima (1)
  Yasuko Hatano (1)
  Keiji Nakano (1)
  Tomohiko Shimo (1)
  Hayato Koshino (2)
  Kazunari Kaneko (1)
  
• 关键词：Egg allergy ; Home ; based oral immunotherapy ; Intermittent loading protocol ; Unlikely to outgrow
• 刊名：Allergy, Asthma & Clinical Immunology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：10
• 期：1
• 全文大小：352 KB
• 参考文献：1. Kurihara K: Immunotherapy for food allergy. / Allergol Int 2010, 59:9-4. CrossRef
  2. Ramesh S: Food allergy overview in children. / Clin Rev Allergy Immunol 2008, 34:217-30. CrossRef
  3. Savage JH, Matsui EC, Skripak JM, Wood RA: The natural history of egg allergy. / J Allergy Clin Immunol 2007, 120:1413-417. CrossRef
  4. Benhamou AH, Caubet JC, Eigenmann PA, Nowak-Wegrzyn A, Marcos CP, Reche M, / et al.: State of the art and new horizons in the diagnosis and management of egg allergy. / Allergy 2010, 65:283-89. CrossRef
  5. de Boissieu D, Dupont C: Natural course of sensitization to hen's egg in children not previously exposed to egg ingestion. / Eur Ann Allergy Clin Immunol 2006, 38:113-17.
  6. Ikematsu K, Tachimoto H, Sugisaki C, Syukuya A, Ebisawa M: Feature of food allergy developed during infancy (2)--acquisition of tolerance against hen's egg, cow's milk, wheat, and soybean up to 3 years old. / Arerugi 2006, 55:533-41.
  7. Imai T, Komata T, Ogata M, Tomikawa M, Tachimoto H, Shukuya A, / et al.: Prolonged type of food allergy. / Arerugi 2007, 56:1285-292.
  8. Sicherer SH, Sampson HA: Food allergy. / J Allergy Clin Immunol 2010, 125:S116-S125. CrossRef
  9. Benhamou AH, Zamora SA, Eigenmann PA: Correlation between specific immunoglobulin E levels and the severity of reactions in egg allergic patients. / Pediatr Allergy Immunol 2008, 19:173-79. CrossRef
  10. Boyano-Martínez T, García-Ara C, Díaz-Pena JM, Martín-Esteban M: Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy. / J Allergy Clin Immunol 2002, 110:304-09. CrossRef
  11. Sopo SM, Onesimo R, Giorgio V, Fundarò C: Specific oral tolerance induction (SOTI) in pediatric age: clinical research or just routine practice? / Pediatr Allergy Immunol 2010, 21:e446-e449. CrossRef
  12. Itoh N, Itagaki Y, Kurihara K: Rush specific oral tolerance induction in school-age children with severe egg allergy: one year follow up. / Allergol Int 2010, 59:43-1. CrossRef
  13. Kaneko H: Japanese pediatric guideline for food allergy 2012. / JJACI 2012, 26:659-63. CrossRef
  14. Burks AW, Jones SM, Wood RA, Fleischer DM, Sicherer SH, Lindblad RW, / et al.: Oral immunotherapy for treatment of egg allergy in children. / N Engl J Med 2012, 367:233-43. CrossRef
  15. Okamoto S, Taniuchi S, Sudo K, Hatano Y, Nakano K, Shimo T, / et al.: Predictive value of IgE/IgG4 antibody ratio in children with egg allergy. / Allergy Asthma Clin Immunol 2012, 8:9. CrossRef
  16. Badina L, Matarazzo L, Longo G, Barbi E: Could slightly cooked egg be a suitable medium for oral immunotherapy in persistent hen's egg allergy? / Allergol Immunopathol (Madr) 2013, 41:141-42. CrossRef
  17. Sampson HA: Anaphylaxis and emergency treatment. / Pediatrics 2003, 111:1601-608.
  18. Ojeda P, Ojeda I, Rubio G, Pineda F: Home-based oral immunotherapy protocol with pasteurized egg for children allergic to hen's egg. / Isr Med Assoc J 2012, 14:34-9.
  19. Meglio P, Giampietro PG, Carello R, Gabriele I, Avitabile S, Galli E: Oral food desensitization in children with IgE-mediated hen's egg allergy: a new protocol with raw hen's egg. / Pediatr Allergy Immunol 2013, 24:75-3. CrossRef
  20. Dello Iacono I, Tripodi S, Calvani M, Panetta V, Verga MC, Miceli SS: Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: a randomized controlled trial. / Pediatr Allergy Immunol 2013, 24:66-4. CrossRef
  21. Vickery BP, Pons L, Kulis M, Steele P, Jones SM, Burks AW: Individualized IgE-based dosing of egg oral immunotherapy and the development of tolerance. / Ann Allergy Asthma Immunol 2010, 105:444-50. CrossRef
  22. Vickery BP: Egg oral immunotherapy. / Curr Opin Allergy Clin Immunol 2012, 12:278-82. CrossRef
  23. Vázquez-Ortiz M, Alvaro-Lozano M, Alsina L, Garcia-Paba MB, Piquer-Gibert M, Giner-Mu?oz MT, / et al.: Safety and predictors of adverse events during oral immunotherapy for milk allergy: severity of reaction at oral challenge, specific IgE and prick test. / Clin Exp Allergy 2013, 43:92-02. CrossRef
  24. Kim EH, Burks W: Managing food allergy in childhood. / Curr Opin Pediatr 2012, 24:615-20. CrossRef
  25. Staden U, Rolinck-Werninghaus C, Brewe F, Wahn U, Niggemann B, Beyer K: Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction. / Allergy 2007, 62:1261-269. CrossRef
  26. Buchanan AD, Green TD, Jones SM, Scurlock AM, Christie L, Althage KA, / et al.: Egg oral immunotherapy in nonanaphylactic children with egg allergy. / J Allergy Clin Immunol 2007, 119:199-05. CrossRef
  27. Barbi E, Longo G, Berti I, Neri E, Saccari A, Rubert L, / et al.: Adverse effects during specific oral tolerance induction: in-hospital "rush" phase. / Eur Ann Allergy Clin Immunol 2012, 44:18-5.
  28. Barbi E, Longo G, Berti I, Matarazzo L, Rubert L, Saccari A, / et al.: Adverse effects during specific oral tolerance induction: in home phase. / Allergol Immunopathol (Madr) 2012, 40:41-0. CrossRef
  
• 作者单位：Kyoko Sudo (1)
  Shoichiro Taniuchi (1)
  Masaya Takahashi (1)
  Kazuhiko Soejima (1)
  Yasuko Hatano (1)
  Keiji Nakano (1)
  Tomohiko Shimo (1)
  Hayato Koshino (2)
  Kazunari Kaneko (1)
  
  1. Department of Pediatrics, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi-shi, Osaka, 570-8506, Japan
  2. Brain Inc, Kyoto, Japan
  
• ISSN：1710-1492

文摘

Background Home based oral immunotherapy (OIT) for food allergy has often been used for young children in Japan, the majority of whom are believed to outgrow the allergy by the school age, therefore the true efficacy of the therapy has been controversial. The aim of this study was to evaluate the efficacy and safety of a newly developed slow- type home-based oral immunotherapy (OIT) regimen in children with hen’s egg (HE) allergy, who had low likelihood of outgrowing the allergy, with treatment involving only elimination diet. Method We retrospectively reviewed the medical records of 43 children with egg allergy (30 males; median age 6) who fulfilled Burks et al.’s criteria of being unlikely to outgrow the allergy. Thirty children who agreed to start OIT were assigned to the treatment group, and 13 who did not want to participate immediately were assigned to the untreated group; the patients underwent an elimination diet for 1?year, during which they were monitored. The OIT regimen involved the intake of the maximum tolerated dose 2 to 3 times a week at home, with initial dose introduction followed by dose build-ups with medical supervision. We statistically evaluated the rate of children who changed their threshold up to 32?g of egg -defined as, oral tolerance induction-in both the groups for 1?year and in the OIT group for 2?years, as well as the rate of children who fulfilled Savage et al.’s criteria of clinical tolerance after reaching the abovementioned remission stage. Results The rate of children who achieved oral tolerance induction to 32?g of egg after 1?year in the OIT group (9/30) was significantly higher than that in the untreated group (0/13). The total rate within the OIT group was significantly increased from 9/30 at 1?year to 17/30 at two years without any severe adverse reaction; of the above 17 children, we followed 14 children, and noted that 11 of these were able to obtain clinical tolerance. Conclusion The home-based OIT with an intermittent loading protocol was very safe and effective in children with a low likelihood of outgrowing egg allergy.