Display options
Share it on

Allergy Rhinol (Providence). 2017 Oct 01;8(3):157-169. doi: 10.2500/ar.2017.8.0211.

Oral immunotherapy in children with IgE-mediated hen's egg allergy: Follow-ups at 2.5 and 7 years.

Allergy & rhinology (Providence, R.I.)

Paolo Meglio, Paolo Gianni Giampietro, Rossella Carello, Elena Galli

Affiliations

  1. From the San Pietro Hospital, Fatebenefratelli Research Center, Rome, Italy.

PMID: 29070273 PMCID: PMC5662541 DOI: 10.2500/ar.2017.8.0211

Abstract

BACKGROUND: The present report was a follow-up investigation at 2.5- and 7-year intervals of a previous study of 20 children with moderate-to-severe immunoglobulin E (IgE) mediated hen's egg (HE) allergy who received oral immunotherapy (OIT) with raw HE. The study design of the previous study divided the 20 subjects into two groups of 10 each: (1) group 1, the OIT group (OIT-G), and, (2) group 2, an age-matched control group (C-G). In that study, 8 of 10 of the children in the OIT-G were successfully desensitized, one child was partially desensitized, and desensitization failed in one child. The aims of the present study were to evaluate the long-term effectiveness and safety profile of OIT with raw HE, and to assess the course and prognostic value of skin-prick tests (SPT) and serum-specific HE-IgEs in this study population.

METHODS: Of the 20 children who were recalled, 2 dropped out, which left 18 to be evaluated. Information on their HE intake was recorded, and SPTs with HE allergen extracts and with raw and hard-boiled HE were performed. Ovomucoid- and ovalbumin-specific IgE levels were also measured.

RESULTS: At the first (2.5-year) and second (7-year) follow-ups, 87.5% of the children in the OIT-G who tolerated raw HE were still tolerant, whereas the children in the C-G were significantly less tolerant. Overall, cutaneous sensitivity to HE significantly decreased after the 6-month desensitization period and at both follow-ups with regard to the OIT-G but not with regard to the C-G. A significant reduction in serum ovomucoid- and ovalbumin-specific IgE levels was seen in both the OIT-G and the C-G.

CONCLUSION: Clinical raw HE tolerance induced by OIT persists over time. Negativization of SPTs could be considered a more reliable prognostic indicator of clinical tolerance to raw HE than the reduction in specific-HE IgE levels. Raw-HE OIT would seem to be a promising method to treat HE allergy.

References

  1. J Allergy Clin Immunol. 2014 Feb;133(2):492-9 - PubMed
  2. Pediatr Allergy Immunol. 1994;5(5 Suppl):1-36 - PubMed
  3. Allergy. 2004 Sep;59(9):980-7 - PubMed
  4. J Allergy Clin Immunol. 2002 Aug;110(2):304-9 - PubMed
  5. Curr Opin Allergy Clin Immunol. 2009 Jun;9(3):244-50 - PubMed
  6. Pediatr Allergy Immunol. 2013 Feb;24(1):66-74 - PubMed
  7. Allergy Asthma Proc. 2016 Sep;37(5):400-3 - PubMed
  8. J Allergy Clin Immunol. 2009 Dec;124(6):1351-2 - PubMed
  9. Pediatr Allergy Immunol. 1998;9(11 Suppl):48-52 - PubMed
  10. Allergy. 2007 Nov;62(11):1261-9 - PubMed
  11. N Engl J Med. 2012 Jul 19;367(3):233-43 - PubMed
  12. Allergol Int. 2010 Mar;59(1):43-51 - PubMed
  13. J Allergy Clin Immunol. 2014 Nov;134(5):1016-25.e43 - PubMed
  14. Asian Pac J Allergy Immunol. 2009 Jun-Sep;27(2-3):107-14 - PubMed
  15. Clin Exp Allergy. 2014 Jan;44(1):130-41 - PubMed
  16. J Allergy Clin Immunol. 2016 Apr;137(4):1117-1127.e10 - PubMed
  17. J Asthma Allergy. 2014 Oct 24;7:141-64 - PubMed
  18. Clin Exp Allergy. 2011 Sep;41(9):1289-96 - PubMed
  19. Asian Pac J Allergy Immunol. 2014 Sep;32(3):195-202 - PubMed
  20. Pediatr Clin North Am. 2011 Apr;58(2):427-43, xi - PubMed
  21. Immunol Allergy Clin North Am. 2015 Feb;35(1):45-59 - PubMed
  22. Arch Dis Child. 1982 Sep;57(9):649-52 - PubMed
  23. J Allergy Clin Immunol. 2008 Jan;121(1):270-1 - PubMed
  24. Allergol Immunopathol (Madr). 2012 Jan-Feb;40(1):41-50 - PubMed
  25. Curr Opin Allergy Clin Immunol. 2013 Jun;13(3):306-14 - PubMed
  26. Curr Allergy Asthma Rep. 2014 Dec;14(12):486 - PubMed
  27. Isr Med Assoc J. 2012 Jan;14(1):34-9 - PubMed
  28. Allergy. 2007 Mar;62(3):335-6 - PubMed
  29. Ann Allergy Asthma Immunol. 2010 Dec;105(6):444-50 - PubMed
  30. Allergy. 2005 Oct;60(10):1320-2 - PubMed
  31. J Allergy Clin Immunol. 2007 Dec;120(6):1413-7 - PubMed
  32. Arch Dis Child. 2003 Jan;88(1):79-81 - PubMed
  33. J Allergy Clin Immunol. 2007 Jan;119(1):199-205 - PubMed
  34. Pediatr Allergy Immunol. 2013 Feb;24(1):75-83 - PubMed
  35. Eur Ann Allergy Clin Immunol. 2007 Jan;39(1):12-9 - PubMed
  36. J Allergy Clin Immunol Pract. 2015 Jul-Aug;3(4):532-9 - PubMed

Publication Types