Oral immunotherapy for the treatment of immediate type food allergy

Sooyoung Lee

doi:10.4168/aard.2014.2.4.229

Journal List > Allergy Asthma Respir Dis > v.2(4) > 1059032

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Lee: Oral immunotherapy for the treatment of immediate type food allergy

Review

Allergy, Asthma & Respiratory Disease 2014; 2(4): 229-235.

Published online: 30 September 2014

DOI: https://doi.org/10.4168/aard.2014.2.4.229

Oral immunotherapy for the treatment of immediate type food allergy

Sooyoung Lee^1,²

¹Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.

²Suwon Center for Environmental Disease and Atopy, Suwon, Korea.

Correspondence to: Sooyoung Lee. Department of Pediatrics, Ajou University School of Medicine, 206 World cup-ro, Yeongtong-gu, Suwon 443-721, Korea. Tel: +82-31-219-5160, Fax: +82-31-219-5169, jsjs87@ajou.ac.kr

Received 3 September 2014 Revised 14 September 2014 Accepted 14 September 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Food allergies continue to increase exponentially and therapies that can modify the natural course of disease is a recent top priority of the research. IgE-mediated food allergy represents both a promising and an intriguing disease of application for allergen specific immunotherapy. In particular, oral immunotherapy (OIT) may offer a novel effective therapeutic modality for persistent and severe forms of food allergies. In such patients, avoidance of the causative foods only may be insufficient because of the risk of unplanned exposure to causative foods. In patients with cow's milk, hen's egg, and peanut allergies, several recently published studies, including meta-analysis, confirmed the overall benefit of OIT. However, the definitive evidence of efficacy and safety with long-term therapeutic or disease-modifying effects is limited. In current protocols, entry indications, and initial-escalating-maintenance doses, the form of antigens, durations, and follow-up periods await to be standardized. Most of the clinical trials of OIT demonstrate effective desensitization, but the ability for inducing long-term tolerance remains to be improved, and the ratio of risks versus benefits of OIT should be considered in detail. The ultimate goal is extending OIT to primary care practice, but at this time, OIT remains within the purview of allergy specialists in terms of associated risk-benefit ratios, related safety, and long-term tolerance induction.

Keywords: Food allergy, Oral immunotherpay, Safety, Tolerance

Figures and Tables

Table 1

Studies that have assessed for tolerance as an outcome after oral immunotherapy

OIT, oral immunotherapy; DBPCFC, double blind placebo controlled food challenge; RCT, randomized controlled trial; OFC, oral food challenge; SLIT, sublingual immunotherapy: OITA, oral immunotherapy group A; OITB, oral immunotherapy group B.

Reviewed and summarized from references 7,13,15,17,22,25,26

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