title: Egg oral immunotherapy in nonanaphylactic children with egg allergy.
abstract: BACKGROUND
  There is no current active treatment for food allergy. Traditional injection immunotherapy has been proved unsafe, and thus there is a need for other forms of immunotherapy.
  
  
  OBJECTIVE
  The purpose was to study the safety and immunologic effects of egg oral immunotherapy (OIT). The short-term goal was to desensitize subjects to protect against accidental ingestion reactions. The eventual goal was to induce lasting clinical and immunologic tolerance.
  
  
  METHODS
  Subjects with a history of egg allergy but without a history of anaphylaxis to egg underwent a 24-month egg OIT protocol involving modified rush, build-up, and maintenance phases. Double-blind, placebo-controlled food challenges were performed at study conclusion. Egg-specific IgE and IgG concentrations were followed.
  
  
  RESULTS
  Seven subjects completed the protocol. Egg-specific IgG concentrations increased significantly, whereas egg-specific IgE concentrations did not significantly change. Three subjects tolerated known or possible accidental egg ingestions while receiving OIT. During double-blind, placebo-controlled food challenges at study conclusion, all tolerated significantly more egg protein than at study onset and than that found in the typical accidental exposure. Two subjects demonstrated oral tolerance.
  
  
  CONCLUSIONS
  This study provides proof of concept that OIT can be safely used for patients with egg allergy without a history of anaphylaxis to egg. Egg OIT does not heighten sensitivity to egg and might protect against reaction on accidental ingestion. Whether OIT will induce clinical oral tolerance cannot be concluded from this initial cohort.
  
  
  CONCLUSIONS
  Use of allergen-specific OIT to protect subjects with food allergy from reaction on accidental ingestion would represent a significant paradigm change in the treatment of food allergy.
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Ariana D
authors.initials: AD
authors.lastname: Buchanan
authors.forename: Todd D
authors.initials: TD
authors.lastname: Green
authors.forename: Stacie M
authors.initials: SM
authors.lastname: Jones
authors.forename: Amy M
authors.initials: AM
authors.lastname: Scurlock
authors.forename: Lynn
authors.initials: L
authors.lastname: Christie
authors.forename: Karen A
authors.initials: KA
authors.lastname: Althage
authors.forename: Pamela H
authors.initials: PH
authors.lastname: Steele
authors.forename: Laurent
authors.initials: L
authors.lastname: Pons
authors.forename: Rick M
authors.initials: RM
authors.lastname: Helm
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Lee
authors.forename: A Wesley
authors.initials: AW
authors.lastname: Burks
mesh_terms: D000284:Administration, Oral; D000707:Anaphylaxis; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D004311:Double-Blind Method; D021181:Egg Hypersensitivity / Q000097:blood / Q000628:therapy*; D004527:Egg Proteins / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant
chemical_list: D004527:Egg Proteins; D007074:Immunoglobulin G; D007073:Immunoglobulin E