Document Detail


Is oral immunotherapy the cure for food allergies?
MedLine Citation:
PMID:  20431369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: To review current evidence on food oral immunotherapy (OIT). RECENT FINDINGS: Desensitized state, defined as the ingestion of a substantial amount of food in the home diet that protects from severe reactions to accidental exposures, can be achieved by approximately 50-75% of the children treated with OIT. The rate of permanent tolerance is unknown; the longer duration of OIT may result in permanent tolerance. Side effects are common both during the initial dose escalation and during home dosing. Most reactions are mild (oral pruritus, abdominal discomfort, and rashes) and decrease in frequency with the longer duration of OIT. Severe reactions treated with epinephrine have been reported during home dosing. Factors associated with increased risk of reactions to previously tolerated doses during home dosing include exercise, viral infection, dosing on empty stomach, menses, and asthma exacerbation. SUMMARY: These preliminary data on OIT are encouraging. Additional studies must answer multiple questions including optimal dose, ideal duration of oral/sublingual immunotherapy, degree of protection, efficacy for different ages, severity and type of food allergy responsive to treatment and need for patient protection during home administration. Until these questions are answered in rigorous multicenter randomized and placebo-controlled trials, OIT remains an experimental approach with not sufficiently well established risk-to-benefit ratio.
Authors:
Anna Nowak-Wegrzyn; Alessandro Fiocchi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in allergy and clinical immunology     Volume:  10     ISSN:  1473-6322     ISO Abbreviation:  Curr Opin Allergy Clin Immunol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100936359     Medline TA:  Curr Opin Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  214-9     Citation Subset:  IM    
Affiliation:
Jaffe Food Allergy Institute and Department of Pediatrics, Mount Sinai School of Medicine, New York, NY 10029, USA. anna.nowak-wegrzyn@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Allergens / administration & dosage*,  adverse effects
Desensitization, Immunologic*
Epinephrine / therapeutic use
Exanthema / drug therapy,  etiology
Food Hypersensitivity / immunology,  therapy*
Humans
Immune Tolerance
Pruritus / drug therapy,  etiology
Risk Assessment
Chemical
Reg. No./Substance:
0/Allergens; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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