Introduction: The first therapeutic choice for food allergy is avoidance of the responsible food, but when this approach is not possible, specific oral desensitization could be considered as a good alternative. It is not clear yet whether the acquired tolerance is transient or persistent. Aim: We report on a subset of 13 patients of a larger study, treated successfully with specific oral tolerance induction who experienced secondary loss of tolerance after a period of allergen avoidance. Material and methods: Thirteen patients affected by IgE-mediated food allergy: to cow milk (3 patients), to hen egg (3 patients), to cod fish (2 patients), to peanuts (1 patient) and to corn (1 patient) confirmed by a complete allergological workup and a double-blind placebo-controlled food challenge (DBPCFC), were treated with sublingual-oral desensitization. After the interruption of the maintenance phase, the laboratory tests were performed and 12 of 13 patients underwent DBPCFC. Results: Oral specific desensitization was completed successfully in all the 13 reported patients. At different times after the end of treatment, they decided, on their own initiative, to stop the ingestion of incriminated food. A new food allergen re-exposure caused adverse reactions in 12 of 13 patients. The detection of specific IgE and IgG4 during the period of allergen avoidance showed an increase in or a stable level of specific IgE and a decrease in specific IgG4 in 8 patients. Conclusions: According to our experience, the tolerance obtained through the desensitizing treatment is transient and so the regular allergen intake is necessary for its maintenance.

Nucera, E., Ricci, A. G., Rizzi, A., Mezzacappa, S., Di Rienzo, A., Pecora, V., Patriarca, G., Buonomo, A., Aruanno, A., Schiavino, D., Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?, <<POSTEPY DERMATOLOGII I ALERGOLOGII>>, 2018; 35 (4): 392-396. [doi:10.5114/ada.2018.77671] [http://hdl.handle.net/10807/135387]

Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?

Nucera;Anna Giulia; Rizzi;Giampiero; Buonomo;Arianna; Schiavino
2018

Abstract

Introduction: The first therapeutic choice for food allergy is avoidance of the responsible food, but when this approach is not possible, specific oral desensitization could be considered as a good alternative. It is not clear yet whether the acquired tolerance is transient or persistent. Aim: We report on a subset of 13 patients of a larger study, treated successfully with specific oral tolerance induction who experienced secondary loss of tolerance after a period of allergen avoidance. Material and methods: Thirteen patients affected by IgE-mediated food allergy: to cow milk (3 patients), to hen egg (3 patients), to cod fish (2 patients), to peanuts (1 patient) and to corn (1 patient) confirmed by a complete allergological workup and a double-blind placebo-controlled food challenge (DBPCFC), were treated with sublingual-oral desensitization. After the interruption of the maintenance phase, the laboratory tests were performed and 12 of 13 patients underwent DBPCFC. Results: Oral specific desensitization was completed successfully in all the 13 reported patients. At different times after the end of treatment, they decided, on their own initiative, to stop the ingestion of incriminated food. A new food allergen re-exposure caused adverse reactions in 12 of 13 patients. The detection of specific IgE and IgG4 during the period of allergen avoidance showed an increase in or a stable level of specific IgE and a decrease in specific IgG4 in 8 patients. Conclusions: According to our experience, the tolerance obtained through the desensitizing treatment is transient and so the regular allergen intake is necessary for its maintenance.
Inglese
Nucera, E., Ricci, A. G., Rizzi, A., Mezzacappa, S., Di Rienzo, A., Pecora, V., Patriarca, G., Buonomo, A., Aruanno, A., Schiavino, D., Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?, <<POSTEPY DERMATOLOGII I ALERGOLOGII>>, 2018; 35 (4): 392-396. [doi:10.5114/ada.2018.77671] [http://hdl.handle.net/10807/135387]
File in questo prodotto:
File Dimensione Formato  
Specific oral immunotherapy in food allergic patients transient or persistent tolerance.pdf

accesso aperto

Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 116.06 kB
Formato Adobe PDF
116.06 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/135387
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 6
social impact