A Safe and Effective Method for Wheat Oral Immunotherapy.

At present the only available management for food allergy is avoidance; however, abstaining from allergic foods can affect the quality of life. Oral Immunotherapy (OIT) is an efficient method for increasing tolerance towards food allergens. The aim of this study was desensitizing patients above five years of age with wheat allergy and evaluating the safety and efficacy of OIT for children with IgE-mediated wheat allergy. The method of Rush Oral Immunotherapy (ROIT) was performed on 8 anaphylactic wheat allergic patients as well as outpatient method on 5 non-anaphylactic ones. In ROIT, build-up phase was performed during several days, but in outpatient, the amount of ingestion gradually increased to 5.2 g wheat protein within several weeks. After that, maintenance doses were prescribed daily for 3 months. Then, if the oral food challenge (OFC) was negative, the patients were considered to be in desensitized state, which meant they had to continue eating same doses without interruption. In ROIT, build-up phase continued for about 4.6 days during which, 21 from 71 doses, showed clinical symptoms (29.6%). On the contrary, outpatient method lasted approximately 72.4 days in which 356 doses were used and symptoms developed in only 9 doses (2.5%). In total -regardless of type of build-up phase- 12 patients could complete the maintenance phase with 1080 doses that 28 of them (2.6%) developed mild symptoms. Our OIT study proved to be safe and effective, although it is utterly evident that further investigation on more patients is necessary.