Is oral immunotherapy the cure for food allergies?

2010 ◽  
Vol 10 (3) ◽  
pp. 214-219 ◽  
Author(s):  
Anna Nowak-Węgrzyn ◽  
Alessandro Fiocchi
Keyword(s):  
Oral Immunotherapy ◽  
Food Allergies

scholarly journals Addressing Common Misconceptions in Food Allergy: A Review

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 497
Author(s):  
Aikaterini Anagnostou
Keyword(s):  
Food Allergy ◽  
The United States ◽  
Specific Ige ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Diagnosis And Management ◽  
Skin Prick Tests ◽  
Food Specific Ige ◽  
Common Misconceptions

Background: Food allergies are common, affecting 1 in 13 school children in the United States and their prevalence is increasing. Many misconceptions exist with regards to food allergy prevention, diagnosis and management. Objective: The main objective of this review is to address misconceptions with regards to food allergies and discuss the optimal, evidence-based approach for patients who carry this diagnosis. Observations: Common misconceptions in terms of food allergy prevention include beliefs that breastfeeding and delayed introduction of allergenic foods prevent the development of food allergies. In terms of diagnosis, statements such as ‘larger skin prick tests or/and higher levels of food-specific IgE can predict the severity of food-induced allergic reactions’, or ‘Tryptase is always elevated in food-induced anaphylaxis’ are inaccurate. Additionally, egg allergy is not a contraindication for receiving the influenza vaccine, food-allergy related fatalities are rare and peanut oral immunotherapy, despite reported benefits, is not a cure for food allergies. Finally, not all infants with eczema will develop food allergies and epinephrine auto-injectors may unfortunately be both unavailable and underused in food-triggered anaphylaxis. Conclusions and relevance: Healthcare professionals must be familiar with recent evidence in the food allergy field and avoid common misunderstandings that may negatively affect prevention, diagnosis and management of this chronic disease.

Oral immunotherapy in food allergies: A practical update for pediatricians

2021 ◽  
Author(s):  
M. Sabouraud ◽  
P. Biermé ◽  
S.-A. Andre-Gomez ◽  
F. Villard-Truc ◽  
A.-K. Corréard ◽  
...  
Keyword(s):  
Oral Immunotherapy ◽  
Food Allergies

scholarly journals Pilot study: Decreasing parental anxiety during peanut oral immunotherapy

2019 ◽  
Vol 10 (3) ◽  
pp. 65
Author(s):  
Kinga P. Olson ◽  
Ruth Rosenblum
Keyword(s):  
Pilot Study ◽  
Pediatric Population ◽  
Oral Immunotherapy ◽  
Careful Consideration ◽  
Food Allergies ◽  
Children And Families ◽  
Convenience Sample ◽  
Parent Survey ◽  
Parents And Children ◽  
Fda Approval

Objective: Peanut allergies are common in the pediatric population. Peanut oral immunotherapy (OIT) can cause anxiety for children and families. A pilot study was conducted to determine what elements parents consider most useful in reducing anxiety within a newly implemented OIT program.Methods: A convenience sample of parents (n = 15) was surveyed to measure perceptions of specific anxiety-reducing elements at a private allergy practice.Results: The 10-question parent survey utilized a Likert Scale measuring how various elements of the OIT program reduced their anxiety. All elements that were provided directly by the clinic received favorable ratings.Discussion and conclusions: Commercially prepared peanut OIT will soon receive FDA approval, and allergy clinics will consider implementing this new therapy for peanut allergic patients. Food allergies invariably cause anxiety for parents and children, therefore careful consideration of how to decrease anxiety during OIT therapy was examined in this pilot study.

scholarly journals A198 EOSINOPHILIC ESOPHAGITIS WITH STRICTURE PRESENTING SHORTING AFTER INITIATION OF ORAL PEANUT IMMUNOTHERAPY

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 71-72
Author(s):  
Z Al Yaarubi ◽  
A Foster ◽  
V Avinashi ◽  
G Lam ◽  
L Soller ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Esophageal Stricture ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Cell Hyperplasia ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
First Case ◽  
Repeat Endoscopy ◽  
Upper Gi Endoscopy

Abstract Background Oral immunotherapy (OIT) is increasingly practiced outside of research settings with reasonable success (Soller 2019). With OIT, a patient eats their food allergen daily, gradually increasing the dose, with the goal to prevent or reduce the severity of an anaphylactic reaction. One of the described adverse events of OIT is a risk of developing Eosinophilic Esophagitis (EoE), with cited frequency of 2.7% (Lucendo 2014). In addition, OIT is typically contraindicated in patients with known EoE but patients are not routinely screened for EoE prior to initiation of OIT. Aims To present a case of a 12 year old boy with peanut anaphylaxis who developed eosinophilic esophagitis and an esophageal stricture shortly after starting peanut immunotherapy Methods Patient chart review was conducted. A literature review was done using the words “eosinophilic esophagitis” and “immunotherapy”. Results A12 year old boy with asthma, allergic rhinitis and multiple anaphylactic food allergies, started peanut OIT with an allergist. Prior to OIT, the patient had no symptoms suggestive of EoE such as dysphagia, heartburn, chest pain or washing of food. Approximately 3.5 weeks into treatment, the patient developed daily vomiting. The patient was advised to stop the peanut OIT three days after symptom onset, but the vomiting continued for another 8 days. By the time of endoscopy (16 days after onset of vomiting), the vomiting had completely subsided for the previous five days. The upper GI endoscopy demonstrated signs of EoE throughout the length of the esophagus. In the mid esophagus there was resistance where the 9.8 mm gastroscope was unable to pass. A smaller gastroscope with a 5.9 mm width was easily able to pass through the stricture. Histology showed marked eosinophilia throughout the esophagus with basal cell hyperplasia, spongiosis, superficial microabscesses and stromal fibrosis consistent with EoE. The patient continued to be ‘asymptomatic’ at the time of endoscopy and after despite the presence of a stricture. After discussion, the patient was started on oral viscous budesonide (OVB) 1mg PO BID. The patient was re-scoped 4 weeks into OVB therapy with complete resolution of the stricture with neither macroscopic nor histologic findings of EoE. Patient is now off OVB for over a month, remains asymptomatic, and will undergo repeat endoscopy in the upcoming month to ensure normal histology Conclusions This is the first case describing EoE with an esophageal stricture shortly after initiation of OIT. Pediatric Gastroenterologists need to be increasingly aware that patients undergoing OIT are at an increasing risk of ‘developing’ or at least ‘unmasking’ EoE. More research is required to evaluate whether EoE screening, by symptom questionnaire or endoscopy is warranted prior to beginning OIT, and whether OIT is truly needed. Upper GI endoscopy showing signs of EoE and an esophageal stricture Funding Agencies CAG

Will We Be Able to Desensitize Food Allergies by Either Injection or Oral Immunotherapy?

2011 ◽  
Vol 11 (4) ◽  
pp. 273-276 ◽  
Author(s):  
Rafael Firszt ◽  
A. Wesley Burks
Keyword(s):  
Oral Immunotherapy ◽  
Food Allergies

Multi-Allergen Oral Immunotherapy Improves Quality of Life in Subjects with Food Allergies

2013 ◽  
Vol 131 (2) ◽  
pp. AB58
Author(s):  
Iris Otani ◽  
Tina L.R. Dominguez ◽  
Alicia Sciancalepore ◽  
Anjuli Mehrotra ◽  
Daniela Pineda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Immunotherapy ◽  
Food Allergies

scholarly journals Weighing the benefits and risks of oral immunotherapy in clinical practice

2021 ◽  
Vol 42 (2) ◽  
pp. 118-123
Author(s):  
Aikaterini Anagnostou
Keyword(s):  
Quality Of Life ◽  
Food Allergy ◽  
The United States ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Allergic Reactions ◽  
Immune Modulators ◽  
Significant Burden ◽  
Working Together

Food allergies are common and affect 6‐8% of children in the United States; they pose a significant burden on the quality of life of children with allergy and their caregivers due to multiple daily restrictions. Despite the recommended dietary avoidance, reactions tend to occur due to unintentional exposure to the allergenic food trigger. Fear of accidental ingestions with potentially severe reactions, including anaphylaxis and death, creates anxiety in individuals with food allergy. Oral immunotherapy has emerged as a form of active and potentially disease-modifying treatment for common food allergies encountered in childhood. The efficacy of oral immunotherapy is high, with the majority of participants achieving desensitization and, as a result, protection from trace exposures and improved quality of life. The main risk of oral immunotherapy consists of allergic reactions to treatment. In general, rates of allergic reactions and anaphylaxis are reported to be higher in individuals pursuing therapy options, but most subjects who undergo oral immunotherapy will likely experience mild or moderate reactions during treatment. Adverse events tend to reduce in both frequency and number in the maintenance period. The use of immune modulators alongside oral immunotherapy has been suggested, with the aim to improve efficacy and safety, and to facilitate the overall process. It is evident that the landscape of food allergy management is changing and that the future looks brighter, with different options emerging over time. The process of how to choose the appropriate option becomes a discussion between the clinician and the patient, which involves a joint review of the current medical evidence but also the patient's preference for balancing particular attributes of the treatment. By working together, providers and patients will ensure achievement of the best possible outcome for children with food allergies.

COLUMNS

2018 ◽  
Vol 22 (04) ◽  
pp. 16-32
Keyword(s):  
Healthcare Providers ◽  
Oral Immunotherapy ◽  
Digital Transformation ◽  
Food Allergies ◽  
Clinical Program ◽  
Smart Hospitals ◽  
The Right

Clinical program for oral immunotherapy for food allergies. Humanities for health: Mediating between the disease, the patient, and the physician. Digital transformation and the rise of smart hospitals. IoT helps healthcare providers deliver the right treatment to the right patient.

scholarly journals Oral Immunotherapy (OIT): A Personalized Medicine

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 684 ◽  
Author(s):  
Francesca Mori ◽  
Simona Barni ◽  
Giulia Liccioli ◽  
Elio Novembre
Keyword(s):  
Personalized Medicine ◽  
Maintenance Dose ◽  
Oral Immunotherapy ◽  
Individualized Treatment ◽  
Food Allergies ◽  
Specific Approach ◽  
Novel Biomarkers

Oral Immunotherapy (OIT), a promising allergen-specific approach in the management of Food Allergies (FA), is based on the administration of increasing doses of the culprit food until reaching a maintenance dose. Each step should be adapted to the patient, and OIT should be considered an individualized treatment. Recent studies focused on the standardization and identification of novel biomarkers in order to correlate endotypes with phenotypes in the field of FA.

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