Oral immunotherapy for hazelnut allergy: a single-center retrospective study on 100 patients

Publication date: Available online 18 November 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Tomas Moraly, Diane Pelletier de Chambure, Stephane Verdun, Christian Preda, Maxime Seynave, Anne-Christine Vilain, Cecile Chenivesse, Christine Delebarre-SauvageAbstractBackgroundOral immunotherapy (OIT) protects patients with IgE-mediated food allergies from food-induced allergic reactions due to accidental exposure and may improve their quality of life. This approach has never been evaluated for hazelnut, a major cause of food allergy in Europe.ObjectiveWe sought to determine the proportion of hazelnut-desensitized patients after 6 months of OIT and to identify predictors of successful desensitization.MethodIn a retrospective single-center study, we included patients under 18 years of age who underwent at least 6 months of hazelnut OIT for IgE-mediated allergy, defined by history of hypersensitivity reaction after hazelnut ingestion, positive hazelnut skin prick test (SPT) or specific IgE, and positive double-blind, placebo-controlled food challenge (DBPCFC). Patients able to tolerate 1635 mg of hazelnut protein (approximately 8 hazelnuts) were considered to be hazelnut desensitized. We determined the proportion of desensitized patients after 6 months of OIT, searched for associations between baseline variables and successful desensitization, and estimated the frequency and severity of OIT-related adverse reactions.ResultsOne hundred patients wer...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research

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AbstractPurpose of ReviewInvestigational allergen immunotherapies (AITs) including oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT) have proven to increase allergen thresholds required to elicit an allergic reaction in a majority of subjects. However, these studies lack consistent biomarkers to predict therapy outcomes. Here, we will review biomarkers that are currently being investigated for AIT.Recent FindingsThe mechanisms underlying the therapeutic benefit of AIT involve various cell types, including mast cells, basophils, T cells, and B cells. Skin prick and basophil act...
Source: Current Allergy and Asthma Reports - Category: Allergy & Immunology Source Type: research
Peanut allergy affects 1-2% of individuals in the United States, and is increasing in prevalence.1-4 Although there is accumulating data on immunotherapy for peanut allergy,5-8 the cornerstone of management remains strict avoidance of peanut protein, maintenance of an emergency action plan and prompt use of epinephrine to treat systemic reactions in case of an accidental exposure, which occurs in up to 12-15% of peanut-allergic individuals annually.9,10 Peanut allergy significantly impacts quality of life,11 as it is typically lifelong, is the leading cause of food-induced anaphylaxis in children, and the leading cause of ...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
This article reviews research advances for sublingual and patch immunotherapy for food allergy with a focus on peanut allergy. Published studies on sublingual immunotherapy (SLIT) and epicutaneous immunotherapy (EPIT) were summarized in this review. Sublingual and epicutaneous methods have emerged as alternatives to oral immunotherapy. SLIT studies have shown modest desensitization with a robust safety profile. EPIT studies have high adherence rates, an excellent safety profile, and potential for desensitization in children. Advances in food immunotherapy with SLIT and EPIT studies have shown promise as viable alternatives...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Immunol Allergy Clin North Am Source Type: research
AbstractPurpose of ReviewOver the last decade, there has been a spark in innovation in the development of therapies for food allergy. Herein, we describe the background and recent advances for food-specific immunotherapies including epicutaneous (EPIT), sublingual (SLIT), and subcutaneous (SCIT).Recent FindingsStudies have progressed most quickly for the treatment of peanut allergy. Data from the phase 3 EPIT trial add to the accumulating evidence that this will be a viable therapy for peanut allergy. Studies for SLIT and SCIT remain in earlier phases with promising results.SummaryThis is an exciting era for the treatment ...
Source: Current Allergy and Asthma Reports - Category: Allergy & Immunology Source Type: research
This article reviews research advances for sublingual and patch immunotherapy for food allergy with a focus on peanut allergy. Published studies on sublingual immunotherapy (SLIT) and epicutaneous immunotherapy (EPIT) were summarized in this review. Sublingual and epicutaneous methods have emerged as alternatives to oral immunotherapy. SLIT studies have shown modest desensitization with a robust safety profile. EPIT studies have high adherence rates, an excellent safety profile, and potential for desensitization in children. Advances in food immunotherapy with SLIT and EPIT studies have shown promise as viable alternatives...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
Food allergy prevalence has increased over the past 2  decades and is estimated to affect 8% of children and 4% to 10% of adults. There is an unmet need to evaluate new therapeutic modalities that may decrease the risk of food-induced anaphylaxis and improve patients’ quality of life. Oral, epicutaneous, and sublingual food immunotherapies have diff erent safety and efficacy profiles, and their long-term outcome and applicability are unclear. Food allergy trials are currently evaluating different biologics (given as monotherapy or adjunct to immunotherapy), modified food proteins, DNA vaccines, and fecal microbiota transplantation.
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
Abstract Food allergies are diseases where the normal tolerance response to oral antigens is altered. Recent advances have begun to uncover mechanisms that mediate sensitization to food allergens and maintenance of the disease. Production of alarmins by epithelial cells triggers a cascade that leads to allergen-specific IgE synthesis. IL-9 has also been shown to play a role in mast cell recruitment and amplification of the allergic response. In recent years, increasing evidence suggests that sensitization to food allergens can be developed via nonoral routes, in particular the skin, thus leading to the "dual ...
Source: Journal of Investigational Allergology and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: J Investig Allergol Clin Immunol Source Type: research
Purpose of review The present review serves to outline the direction of food allergy immunotherapy research with an emphasis on clinical and immunologic outcomes. It helps to delineate sustained unresponsiveness achieved from food immunotherapy as the clinical outcome most similar to immune tolerance. Recent findings We will discuss the difference between immune tolerance, desensitization, and sustained unresponsiveness in relation to food immunotherapy by discussing the clinical and immunologic changes which have been recently discovered. Summary Research has recently shown that oral immunotherapy is most efficaci...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
Oral immunotherapy (OIT) for food allergy entails a risk of adverse reactions, including anaphylaxis. This safety concern is the major barrier for OIT to become a therapeutic option in clinical practice. The high heterogeneity in safety reporting of OIT studies prevents setting the safety profile accurately. An international consensus is needed to facilitate the analysis of large pooled clinical data with homogeneous safety reporting, that together with integrated omics, and patients/families ’ opinions, may help stratify the patients’ risk and needs, and help developing safe(r) individualized care pathways. Th...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
Food allergies are a growing public health concern affecting approximately 8% of children and 10% of adults in the United States. Several immunotherapy approaches are under active investigation, including oral immunotherapy, epicutaneous immunotherapy, and sublingual immunotherapy. Each of these approaches uses a similar strategy of administering small, increasing amounts of allergen to the allergic subject. Immunologic studies have described changes in the T-cell compartment, serum and salivary immunoglobulin profile, and mast cell and basophil degranulation status in response to allergens. This review highlights the immu...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
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