Oral and sublingual immunotherapy for food allergy.

OBJECTIVE: Food allergies continue to be an increasingly common disorder, however, no treatment strategies are currently approved for the routine management of individuals with food allergies. Encouraging results from early open-label studies have sparked great interest in oral and sublingual immunotherapy, and thus several randomized controlled trials have recently been conducted to establish the safety and efficacy of these treatment strategies. The aim of this review is to examine the recent studies for peanut, milk and egg allergies. DATA SOURCES: Open-label and randomized control trials are discussed. STUDY SELECTIONS: Studies focusing on peanut, milk and egg allergies are included.
RESULTS: Current evidence indicates that desensitization is possible for the majority of subjects who undergo oral immunotherapy. Clinical improvement has been associated with favorable immunologic changes, including smaller skin prick test wheal sizes and increased allergen-specific IgG4 levels. Adverse reactions are common, however, and thus safety concerns remain. Sublingual immunotherapy thus far has not proven to be as effective as oral immune-therapy.
CONCLUSION: Oral and sublingual immunotherapy are promising treatments for food allergy. Optimization and standardization of protocols, along with additional assessments of safety are still needed.