REVIEW PAPER
Oral immunotherapy in children for the most common food allergy
1
Student Research Group of Adult Allergology, Wroclaw Medical University, Wroclaw, Poland Head of the Group: Krzysztof Gomułka MD, PhD
2
Faculty of Medicine, University of Opole, Opole, Poland Head of the Faculty: Jacek Jóźwiak PhD
3
Department of Internal Medicine, Pneumology, and Allergology, Wroclaw Medical University, Wroclaw, Poland Head of the Department: Robert Pawłowicz MD, PhD
Submission date: 2022-04-25
Final revision date: 2022-07-22
Acceptance date: 2022-08-25
Publication date: 2022-09-30
Medical Studies 2022;38(3):210-220
KEYWORDS
TOPICS
ABSTRACT
Nowadays, the incidence of food allergies is increasing. While strict allergen avoidance remains the most important therapeutic approach, oral immunotherapy is increasingly being used to desensitize and induce tolerance in children. Oral immunotherapy is a possible treatment for food allergies, which includes the administration of gradually increasing doses of the allergen. While most children can be desensitized, or even gain sustained unresponsiveness, oral immunotherapy involves a high risk of side effects or allergic responses with a need to use epinephrine, and the long-term effectiveness is unknown. In this paper, we summarize recent clinical trials in which oral immunotherapy has been used to treat common food allergies: to cow’s milk, peanuts, and chicken eggs.
REFERENCES (40)
1.
Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol 2014; 133: 291-308.
2.
Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A, EAACI Food Allergy and Anaphylaxis Guidelines Group. Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy 2014; 69: 992-1007.
3.
Sasaki M, Peters RL, Koplin JJ, Field MJ, McWilliam V, Sawyer SM, Vuillermin PJ, Pezic A, Gurrin LC, Douglass JA, Tang MLK, Dharmage SC, Allen KJ. Risk factors for food allergy in early adolescence: the SchoolNuts Study. J Allergy Clin Immunol Pract 2018; 6: 496-505.
4.
Manuyakorn W, Tanpowpong P. Cow milk protein allergy and other common food allergies and intolerances. Paediatr Int Child Health 2019; 39: 32-40.
5.
Freeland DMH, Manohar M, Andorf S, Hobson BD, Zhang W, Nadeau KC. Oral immunotherapy for food allergy. Semin Immunol 2017; 30: 36-44.
6.
Szczepanik M, Majewska-Szczepanik M. Transdermal immunotherapy: past, present and future. Pharmacol Rep 2016; 68: 773-781.
8.
Wood RA. Food allergen immunotherapy: current status and prospects for the future. J Allergy Clin Immunol 2016; 137: 973-982.
9.
Wilk M, Ptak J, Tomczyk B, Kruczkowska A, Kanturski A, Gomułka K. A review of the mechanisms and biomarkers of allergen immunotherapy. Medical Studies 2021; 37: 322-330.
10.
Ogata M, Kido J, Nakamura K. Oral immunotherapy for children with cow’s milk allergy. Pathogens 2021; 10: 1328.
11.
Eigenmann PA. Anaphylaxis to cow’s milk and beef meat proteins. Ann Allergy Asthma Immunol 2002; 89 (6 Suppl 1): 61-64.
12.
Meglio P, Giampietro PG, Gianni S, Galli E. Oral desensitization in children with immunoglobulin E-mediated cow’s milk allergy: follow-up at 4 yr and 8 months. Pediatr Allergy Immunol 2008; 19: 412-419.
13.
Longo G, Barbi E, Berti I, Meneghetti R, Pittalis A, Ronfa- ni L, Ventura A. Specific oral tolerance induction in children with very severe cow’s milk-induced reactions. J Allergy Clin Immunol 2008; 121: 343-347.
14.
Skripak JM, Nash SD, Rowley H, Brereton NH, Oh S, Hamilton RG, Matsui EC, Burks AW, Wood RA. A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow’s milk allergy. J Allergy Clin Immunol 2008; 122: 1154-1160.
15.
Pajno GB, Caminiti L, Ruggeri P, De Luca R, Vita D, La Rosa M, Passalacqua G. Oral immunotherapy for cow’s milk allergy with a weekly up-dosing regimen: a randomized single-blind controlled study. Ann Allergy Asthma Immunol 2010; 105: 376-381.
16.
Martorell A, De la Hoz B, Ibáñez MD, Bone J, Terra- dos MS, Michavila A, Plaza AM, Alonso E, Garde J, Ne- vot S, Echeverria L, Santana C, Cerdá JC, Escudero C, Guallar I, Piquer M, Zapatero L, Ferré L, Bracamonte T, Muriel A, Martínez MI, Félix R. Oral desensitization as a useful treatment in 2-year-old children with cow’s milk allergy. Clin Exp Allergy 2011; 41: 1297-1304.
17.
Salmivesi S, Korppi M, Mäkelä MJ, Paassilta M. Milk oral immunotherapy is effective in school-aged children. Acta Paediatr 2013; 102: 172-176.
18.
Keet CA, Frischmeyer-Guerrerio PA, Thyagarajan A, Schroeder JT, Hamilton RG, Boden S, Steele P, Driggers S, Burks AW, Wood RA. The safety and efficacy of sublingual and oral immunotherapy for milk allergy. J Allergy Clin Immunol 2012; 129: 448-455.
19.
Inuo C, Tanaka K, Suzuki S, Nakajima Y, Yamawaki K, Tsuge I, Urisu A, Kondo Y. Oral immunotherapy using partially hydrolyzed formula for cow’s milk protein allergy: a randomized, controlled trial. Int Arch Allergy Immunol 2018; 177: 259-268.
20.
Wood RA, Kim JS, Lindblad R, Nadeau K, Henning AK, Dawson P, Plaut M, Sampson HA. A randomized, double- blind, placebo-controlled study of omalizumab combined with oral immunotherapy for the treatment of cow’s milk allergy. J Allergy Clin Immunol 2016; 137: 1103-1110.e11.
21.
Takahashi M, Soejima K, Taniuchi S, Hatano Y, Yamanouchi S, Ishikawa H, Irahara M, Sasaki Y, Kido H, Kane- ko K. Oral immunotherapy combined with omalizumab for high-risk cow’s milk allergy: a randomized controlled trial. Sci Rep 2017; 7: 17453.
22.
Jones SM, Pons L, Roberts JL, Scurlock AM, Perry TT, Kulis M, Shreffler WG, Steele P, Henry KA, Adair M, Fran- cis JM, Durham S, Vickery BP, Zhong X, Burks AW. Clinical efficacy and immune regulation with peanut oral immunotherapy. J Allergy Clin Immunol 2009; 124: 292-300.e3097.
23.
Kukkonen AK, Uotila R, Malmberg LP, Pelkonen AS, Mäkelä MJ. Double-blind placebo-controlled challenge showed that peanut oral immunotherapy was effective for severe allergy without negative effects on airway inflammation. Acta Paediatr 2017; 106: 274-281.
24.
Bird JA, Spergel JM, Jones SM, Rachid R, Assa’ad AH, Wang J, Leonard SA, Laubach SS, Kim EH, Vickery BP, Davis BP, Heimall J, Cianferoni A, MacGinnitie AJ, Cresta- ni E, Burks AW, ARC001 Study Group. Efficacy and safety of AR101 in oral immunotherapy for peanut allergy: results of ARC001, a randomized, double-blind, placebo-controlled phase 2 clinical trial. J Allergy Clin Immunol Pract 2018; 6: 476-485.e3.
25.
PALISADE Group of Clinical Investigators, Vickery BP, Vereda A, Casale TB, Beyer K, du Toit G, Hourihane JO, Jones SM, Shreffler WG, Marcantonio A, Zawadzki R, Sher L, Carr WW, Fineman S, Greos L, Rachid R, Dolores Ibáñez M, Tilles S, Assa’ad AH, Nilsson C, Rupp N, Welch MJ, Sussman G, Chinthrajah S, Blumchen K, Sher E, Spergel JM, Leickly FE, Zielen S, Wang J, San- ders GM, Wood RA, Cheema A, Bindslev-Jensen C, Leonard S, Kachru R, Johnston DT, Hampel Jr FC, Kim EH, Anagnostou A, Pongracic JA, Ben-Shoshan M, Sharma HP, Stillerman A, Windom HH, Yang WH, Muraro A, Zubel- dia JM, Sharma V, Dorsey MJ, Chong HJ, Ohayo J, Bird JA, Carr TF, Siri D, Fernández-Rivas M, Jeong DK, Flei- scher DM, Lieberman JA, Dubois AEJ, Tsoumani M, Ciaccio CE, Portnoy JM, Mansfield LE, Fritz SB, Lanser BJ, Matz J, Oude Elberink HNG, Varshney P, Dilly SG, Adelman DC, Burks AW. AR101 oral immunotherapy for peanut allergy. N Engl J Med 2018; 379: 1991-2001.
26.
Nagakura KI, Yanagida N, Sato S, Nishino M, Asaumi T, Ogura K, Ebisawa M. Low-dose oral immunotherapy for children with anaphylactic peanut allergy in Japan. Pediatr Allergy Immunol 2018; 29: 512-518.
27.
Blumchen K, Trendelenburg V, Ahrens F, Gruebl A, Hamelmann E, Hansen G, Heinzmann A, Nemat K, Holzhauser T, Roeder M, Rosenfeld L, Hartmann O, Niggemann B, Beyer K. Efficacy, safety, and quality of life in a multicenter, randomized, placebo-controlled trial of low-dose peanut oral immunotherapy in children with peanut allergy. J Allergy Clin Immunol Pract 2019; 7: 479-491.
28.
Jones SM, Kim EH, Nadeau KC, Nowak-Wegrzyn A, Wood RA, Sampson HA, Scurlock AM, Chinthrajah S, Wang J, Pesek RD, Sindher SB, Kulis M, Johnson J, Spain K, Babineau D, Chin H, Laurienzo-Panza J, Yan R, Larson D, Qin T, Whitehouse D, Sever ML, Sanda S, Plaut M, Wheatley LM, Burks AW, Immune Tolerance Network. Efficacy and safety of oral immunotherapy in children aged 1-3 years with peanut allergy (the Immune Tolerance Network IMPACT trial): a randomised placebo- controlled study. Lancet 2022; 399: 359-371.
29.
Fleischer DM, Greenhawt M, Sussman G, Bégin P, Nowak-Wegrzyn A, Petroni D, Beyer K, Brown-Whitehorn T, Hebert J, Hourihane JOB, Campbell DE, Leonard S, Chinthrajah RS, Pongracic JA, Jones SM, Lange L, Chong H, Green TD, Wood R, Cheema A, Prescott SL, Smith P, Yang W, Chan ES, Byrne A, Assa’ad A, Bird JA, Kim EH, Schneider L, Davis CM, Lanser BJ, Lambert R, Shreffler W. Effect of epicutaneous immunotherapy vs placebo on reaction to peanut protein ingestion among children with peanut allergy: the PEPITES randomized clinical trial. JAMA 2019; 321: 946-955.
30.
Kim EH, Yang L, Ye P, Guo R, Li Q, Kulis MD, Burks AW. Long-term sublingual immunotherapy for peanut allergy in children: Clinical and immunologic evidence of desensitization. J Allergy Clin Immunol 2019; 144: 1320-1326.
31.
Graham F, Tardio N, Paradis L, Des Roches A, Bégin P. Update on oral immunotherapy for egg allergy. Hum Vaccin Immunother 2017; 13: 2452-2461.
32.
Burks AW, Jones SM, Wood RA, Fleischer DM, Siche- rer SH, Lindblad RW, Stablein D, Henning AK, Vicke- ry BP, Liu AH, Scurlock AM, Shreffler WG, Plaut M, Sam- pson HA, Consortium of Food Allergy Research (CoFAR). Oral immunotherapy for treatment of egg allergy in children. N Engl J Med 2012; 367: 233-243.
33.
Staden U, Rolinck-Werninghaus C, Brewe F, Wahn U, Niggemann B, Beyer K. Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction. Allergy 2007; 62: 1261-1269.
34.
Buchanan AD, Green TD, Jones SM, Scurlock AM, Christie L, Althage KA, Steele PH, Pons L, Helm RM, Lee LS, Burks AW. Egg oral immunotherapy in nonanaphylactic children with egg allergy. J Allergy Clin Immunol 2007; 119: 199-205.
35.
Palosuo K, Karisola P, Savinko T, Fyhrquist N, Alenius H, Mäkelä MJ. A randomized, open-label trial of hen’s egg oral immunotherapy: efficacy and humoral immune responses in 50 children. J Allergy Clin Immunol Pract 2021; 9: 1892-1901.
36.
Maeta A, Matsushima M, Muraki N, Asano M, Takaoka Y, Kameda M, Takahashi K. Low-dose oral immunotherapy using low-egg-allergen cookies for severe egg-allergic children reduces allergy severity and affects allergen-specific antibodies in serum. Int Arch Allergy Immunol 2018; 175: 70-76.
37.
Escudero C, Rodríguez Del Río P, Sánchez-García S, Pérez- Rangel I, Pérez-Farinós N, García-Fernández C, Ibá- ñez MD. Early sustained unresponsiveness after short-course egg oral immunotherapy: a randomized controlled study in egg-allergic children. Clin Exp Allergy 2015; 45: 1833-1843.
38.
Umetsu DT, Rachid R, Schneider LC. Oral immunotherapy and anti-IgE antibody treatment for food allergy. World Allergy Organ J 2015; 8: 20.
39.
Chu DK, Wood RA, French S, Fiocchi A, Jordana M, Waserman S, Brożek JL, Schünemann HJ. Oral immunotherapy for peanut allergy (PACE): a systematic review and meta-analysis of efficacy and safety. Lancet 2019; 393: 2222-2232.
40.
Mori F, Cianferoni A, Brambilla A, Barni S, Sarti L, Pucci N, de Martino M, Novembre E. Side effects and their impact on the success of milk oral immunotherapy (OIT) in children. Int J Immunopathol Pharmacol 2017; 30: 182-187.
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| ISSN: | 1899-1874 |
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