Yoko Miura1, Ken-Ichi Nagakura1,2, Makoto Nishino1,3, Mari Takei4, Kyohei Takahashi1,3, Tomoyuki Asaumi1, Kiyotake Ogura1,3, Sakura Sato3,4, Motohiro Ebisawa4, Noriyuki Yanagida1. 1. Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan. 2. Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan. 3. Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan. 4. Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
Abstract
BACKGROUND: The efficacy and safety of cow's milk (CM) low-dose oral immunotherapy (LOIT) at one-year follow-up have been previously reported. We investigated the outcome of fixed long-term LOIT in children with severe CM allergy. METHODS: Children with positive reactions to oral food challenge (OFC) with 3 mL CM were included. The LOIT group (n = 33) ingested up to 3 mL CM for 1 year. After a two-week CM avoidance, 3 and 25 mL OFCs were performed. Children with positive reactions continued with 3 mL ingestion, with OFCs repeated yearly. Regular home consumption of 25 mL CM after passing the OFCs was defined as 25 mL short-term unresponsiveness (25 mL STU). The historical control group (n = 16) with reactions to 3 mL OFC eliminated daily CM ingestion. RESULTS: The proportion of 25 mL STU in the LOIT group was 27%, 52%, and 61% after 1, 2, and 3 years, respectively, and the 3-year percentage was significantly higher than that in the historical control group (13%, P = .002). In the LOIT group, only one child developed severe symptoms. Furthermore, in this group, CM- and casein-specific immunoglobulin E (sIgE) levels decreased significantly and casein-specific IgG and IgG4 levels increased significantly after 3 years, whereas the historical control group presented no significant change in these parameters. Baseline sIgE levels were significantly low in children achieving 25 mL STU. CONCLUSION: Continued fixed LOIT yields immunologic improvement and may be effective and safe for severe CM allergy.
BACKGROUND: The efficacy and safety of cow's milk (CM) low-dose oral immunotherapy (LOIT) at one-year follow-up have been previously reported. We investigated the outcome of fixed long-term LOIT in children with severe CM allergy. METHODS:Children with positive reactions to oral food challenge (OFC) with 3 mL CM were included. The LOIT group (n = 33) ingested up to 3 mL CM for 1 year. After a two-week CM avoidance, 3 and 25 mL OFCs were performed. Children with positive reactions continued with 3 mL ingestion, with OFCs repeated yearly. Regular home consumption of 25 mL CM after passing the OFCs was defined as 25 mL short-term unresponsiveness (25 mL STU). The historical control group (n = 16) with reactions to 3 mL OFC eliminated daily CM ingestion. RESULTS: The proportion of 25 mL STU in the LOIT group was 27%, 52%, and 61% after 1, 2, and 3 years, respectively, and the 3-year percentage was significantly higher than that in the historical control group (13%, P = .002). In the LOIT group, only one child developed severe symptoms. Furthermore, in this group, CM- and casein-specific immunoglobulin E (sIgE) levels decreased significantly and casein-specific IgG and IgG4 levels increased significantly after 3 years, whereas the historical control group presented no significant change in these parameters. Baseline sIgE levels were significantly low in children achieving 25 mL STU. CONCLUSION: Continued fixed LOIT yields immunologic improvement and may be effective and safe for severe CM allergy.
Authors: Antonio Bognanni; Derek K Chu; Ramon T Firmino; Stefania Arasi; Siw Waffenschmidt; Arnav Agarwal; Piotr Dziechciarz; Andrea Horvath; Rime Jebai; Hanako Mihara; Yetiani Roldan; Maria Said; Raanan Shamir; Martin Bozzola; Sami Bahna; Alessandro Fiocchi; Susan Waserman; Holger J Schünemann; Jan L Brożek Journal: World Allergy Organ J Date: 2022-09-08 Impact factor: 5.516
Authors: Cristobalina Mayorga; Francisca Palomares; José A Cañas; Natalia Pérez-Sánchez; Rafael Núñez; María José Torres; Francisca Gómez Journal: Foods Date: 2021-05-10