Oral immunotherapy (OIT)
is an attractive
strategy for active
treatment of IgE-mediated
food allergy.
Multiple egg OIT
studies have been
published to date,
but many are
uncontrolled.
Furthermore,
interpretation of
the results is
difficult because of
significant
heterogeneity in
design, aims, and
population. Most
studies have
demonstrated the
potential of egg OIT
to induce
desensitization,
albeit to different
extents (0%-100% of
patients). However,
few studies have
explored the
capacity of OIT to
maintain tolerance,
that is, enabling
the patient to
continue consuming
egg after suspension
of therapy.
Nowadays, 28% to 75%
of patients maintain
tolerance after 1 to
3 months of their
elimination diet.
Adverse effects are
the main drawback of
this treatment,
which is still not
recommended in
routine practice.
Adverse reactions
are not reported
homogeneously, with
the result that it
is difficult to
properly assess
outcomes. The
overall impression
is that adverse
reactions affect
most patients and
tend to be frequent,
although of mild to
moderate severity.
Nevertheless, severe
events such as
anaphylaxis or
eosinophilic
esophagitis may also
occur. Immunological
changes resulting
from egg OIT, for
example, the
decrease in the size
of the skin prick
test wheal and the
levels of egg white
sIgE and a
significant early
increase in egg
white sIgG4, have
been reported.
Several areas of egg
OIT remain unclear,
including patient
selection, materials
used, dosing
schedule, treatment
duration, long-term
maintained
effectiveness,
requirements for
implementation in
clinical practice,
influence on quality
of life, and
cost-effectiveness
of treatment.
In this review, we
provide an in-depth
examination of
methodological
differences between
studies in order to
understand the
diversity in the
efficacy and safety
results of the
procedures used in
egg OIT.
Key words:
Oral Immunotherapy.
Egg desensitization.
Egg tolerance.
Food-immunotherapy.
Egg allergy. Adverse
events. Adverse
reactions. Treatment
of food allergy |