PMID- 17919140
OWN - NLM
STAT- MEDLINE
DCOM- 20080129
LR  - 20220321
IS  - 0105-4538 (Print)
IS  - 0105-4538 (Linking)
VI  - 62
IP  - 11
DP  - 2007 Nov
TI  - Specific oral tolerance induction in food allergy in children: efficacy and 
      clinical patterns of reaction.
PG  - 1261-9
AB  - BACKGROUND: Specific oral tolerance induction (SOTI) seems to be a promising 
      treatment of food allergy. Specific oral tolerance induction and elimination diet 
      were compared with respect to efficacy rate and patterns of clinical reaction. 
      METHODS: Children with challenge proven immunoglobulin E (IgE)-mediated cow's 
      milk (CM) allergy or hen's egg (HE) allergy were randomly assigned to SOTI or 
      elimination diet as a control group. Specific oral tolerance induction treatment 
      was performed at home on a daily basis according to a study protocol with fresh 
      CM or lyophilized HE protein. Re-evaluation of clinically relevant food allergy 
      was performed by food challenge after a median of 21 months. Children in the SOTI 
      group received a secondary elimination diet for 2 months prior to follow-up 
      challenge to evaluate persistence of induced oral tolerance. RESULTS: At 
      follow-up challenge, nine of 25 children (36%) showed permanent tolerance in the 
      SOTI group, three of 25 (12%) were tolerant with regular intake and four of 25 
      (16%) were partial responders. In the control group, seven of 20 children (35%) 
      were tolerant. Allergen-specific immunoglobulin E decreased significantly both in 
      children who developed natural tolerance during the elimination diet (P < 0.05) 
      and in those with SOTI (P < 0.001). CONCLUSIONS: Specific oral tolerance 
      induction seems a valid treatment option for patients with persistent food 
      allergy. Indications may be given if avoidance cannot be guaranteed or for those 
      who are eager to eat the food in question. Advantages of SOTI are the increased 
      threshold dose for allergic reactions and the substantially reduced risk of 
      severe allergic reactions after inadvertent ingestion of the allergen. However, 
      careful monitoring during SOTI is mandatory.
FAU - Staden, U
AU  - Staden U
AD  - Department of Pediatric Pneumology and Immunology, University Children's Hospital 
      Charite, Berlin, Germany.
FAU - Rolinck-Werninghaus, C
AU  - Rolinck-Werninghaus C
FAU - Brewe, F
AU  - Brewe F
FAU - Wahn, U
AU  - Wahn U
FAU - Niggemann, B
AU  - Niggemann B
FAU - Beyer, K
AU  - Beyer K
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Administration, Oral
MH  - Adolescent
MH  - Allergens/*administration & dosage/immunology
MH  - Child
MH  - Child, Preschool
MH  - *Desensitization, Immunologic/adverse effects
MH  - Egg Hypersensitivity/diet therapy/immunology/*therapy
MH  - Female
MH  - Humans
MH  - Immune Tolerance
MH  - Immunoglobulin E/*blood/immunology
MH  - Infant
MH  - Male
MH  - Milk Hypersensitivity/diet therapy/immunology/*therapy
EDAT- 2007/10/09 09:00
MHDA- 2008/01/30 09:00
CRDT- 2007/10/09 09:00
PHST- 2007/10/09 09:00 [pubmed]
PHST- 2008/01/30 09:00 [medline]
PHST- 2007/10/09 09:00 [entrez]
AID - ALL1501 [pii]
AID - 10.1111/j.1398-9995.2007.01501.x [doi]
PST - ppublish
SO  - Allergy. 2007 Nov;62(11):1261-9. doi: 10.1111/j.1398-9995.2007.01501.x.