Oral and sublingual immunotherapy for egg allergy.

CONCLUSIONS: Frequent and increasing exposure to egg over one to two years in people who are allergic to egg builds tolerance, with almost everyone becoming more tolerant compared with a minority in the control group and almost half of people being totally tolerant of egg by the end of treatment compared with 1 in 10 people who avoid egg. However, nearly all who received treatment experienced adverse events, mainly allergy-related. We found that 1 in 12 children had serious allergic reactions requiring adrenaline, and some people gave up oral immunotherapy. It appears that oral immunotherapy for egg allergy is effective, but confidence in the trade-off between benefits and harms is low; because there was a small number of trials with few participants, and methodological problems with some trials. PMID: 29676439 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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Although the practical application of oral immunotherapy for food allergy (FOIT) is routine in Japan1 and common in Europe,2,3 it continues to be controversial in North America.4 It is not the intention of this report to engage in that polemic, but rather to acknowledge that there are at least dozens of allergists in North America treating thousands of food allergic patients with FOIT. We do not contend that collections of anecdotes are the same as data. We do believe, however, that questions arise in the day-to-day practice of food allergy treatment that must be addressed, but are unlikely to be the subject of prospective, controlled trials.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Perspective Source Type: research
AbstractOral immunotherapy (OIT) has been shown to be effective for inducing desensitization in children with cow ’s milk and egg allergy. In contrast, there is limited evidence that OIT can induce tolerance or sustained unresponsiveness in food allergic patients. Sustained unresponsiveness, determined by a food challenge following a period of secondary avoidance, has been suggested to reflect a more enduring state of tolerance and is pertinent when considering the ability of OIT to shorten the duration of food allergy. While it has been shown that children who tolerate baked forms of egg and milk are more likely to ...
Source: World Allergy Organization Journal - Category: Allergy & Immunology Source Type: research
AbstractThe development of oral tolerance or food allergy is an active process, related to dynamic interactions between host immune cells, microbiome, dietary factors, and food allergens. Oral tolerance is the default immune response in the gut. A food allergy occurs when this process fails and a pathologic Th2 response is activated. Oral food immunotherapy (OIT) aims to restore immune tolerance in food-allergic individuals. The stimulation of Tregs production seems to represent a crucial step in inducing long-term tolerance, but other mechanisms (e.g., the suppression of mast cell and basophil reactivity, changes in aller...
Source: World Allergy Organization Journal - Category: Allergy & Immunology Source Type: research
AbstractPurpose of ReviewThis review aims to provide an update of recent advances in the epidemiology, clinical features and diagnosis, and management of food-induced anaphylaxis (FIA).Recent FindingsFood allergy prevalence and FIA rates continue to rise, but FIA fatalities are stable. Basophil and mast cell activation tests promise more accurate identification of food triggers. Oral, sublingual, and epicutaneous immunotherapy can desensitize a significant portion of subjects. Epinephrine use for FIA remains sub-optimal.SummaryAs the burden of food allergy continues to increase, it appears that the corresponding increase i...
Source: Current Allergy and Asthma Reports - Category: Allergy & Immunology Source Type: research
AbstractThe prevalence of food allergy has been increasing over the past few decades at an alarming rate with peanut allergy affecting about 2% of children. Both oral immunotherapy (OIT) and sublingual immunotherapy (SLIT) have shown promise as a  treatment option for peanut allergy. Immunotherapy induces desensitization and reduces the risk of reaction during accidental ingestion and may also enable those who are successfully desensitized to include the food allergen in their diet. OIT has been very well studied and has been found to be mo re efficacious than SLIT with an acceptable safety profile. However, SLIT is a...
Source: Allergo Journal International - Category: Allergy & Immunology Source Type: research
CONCLUSIONS: Generally, PFAS can't be expected to remit naturally. SCIT with birch pollen extract effectively reduces OAS symptoms, and it can be expected as a radical therapy for PFAS. PMID: 29769472 [PubMed - in process]
Source: Arerugi - Category: Allergy & Immunology Authors: Tags: Arerugi Source Type: research
Purpose of review Allergen immunotherapy (AIT) is a well recognized and extensively studied therapeutic intervention for some allergic diseases. Every year new systematic reviews and meta-analysis provide the most powerful source of evidence to orient decision making on prevention or efficacy of AIT. We here discuss systematic reviews and meta-analyses on AIT (published January 2017 to February 2018). Recent findings We identified 4 systematic reviews and 10 meta-analyses. Subcutaneous and sublingual AIT (SCIT/SLIT) significantly reduced the development of asthma in children–adolescents with moderate/severe alle...
Source: Current Opinion in Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: OUTCOME MEASURES: Edited by Henry Milgrom and René Maximiliano Gómez Source Type: research
Purpose of review The prevalence of food allergy is increasing. More children are being diagnosed with food allergies, and it is taking longer to outgrow them, among those who develop tolerance. The aim of this review is to draw the profile of the persistent food allergic, so that prevention strategies can be developed and active treatment set up. Recent findings Many determinants are involved in food allergy prognosis: ethnicity and sex, type of food, innate immune system, eliciting dose, sensitization status and other biomarkers determination, gut microbiome composition, and the presence of comorbidities. Once ident...
Source: Current Opinion in Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research
Purpose of review In the last years, food allergy treatment is moving away from food avoidance to interventional treatments. We review here the recent developments on immunotherapy with food allergens. Recent findings Oral immunotherapy remains the best studied form of food immunotherapy. In 2017, further evidence has been added to its efficacy. Its mechanisms of action are under scrutiny. To reduce its side effects, studies have been dedicated to the simultaneous use of biologics, in particular omalizumab. Among the other forms of food immunotherapy that are being developed, the epicutaneous application of food aller...
Source: Current Opinion in Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: FOOD ALLERGY: Edited by Alessandro Fiocchi and Motohiro Ebisawa Source Type: research
Cow's milk allergy (CMA) is one of the most common food allergies and a critical public health problem in the case of children.1 Oral immunotherapy and oral food challenges have been developed for treating and diagnosing food allergies, but anaphylactic reactions occasionally occur during immunotherapy.E1 To avoid fatal allergic reactions during allergen-specific immunotherapy as well as oral food challenges, peptide-based approaches represent a safer option that might be used in the future with small peptides that contain T-cell epitope sequences, but avoid cross-reactions with IgE.
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Letter to the Editor Source Type: research
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