title: Efficacy of oral immunotherapy protocol for specific oral tolerance induction in children with cow's milk allergy.
abstract: BACKGROUND
  In the last two decades milkoralimmunotherapy has gained interest as an effective treatment option for milk-allergic patients.
  
  
  OBJECTIVE
  To report on the efficacy of a milk oral immunotherapy.
  
  
  METHODS
  Children with immunoglobulin E-mediated cow's milk allergy were included in the protocol. The treatment consisted of an induction phase in which milk doses were increased weekly in the hospital, while the tolerated dose was continued daily at home. The goal was to achieve a minimum milk intake of 200 ml a day. During the maintenance phase, patients ingested at least 200 ml of milk in a single dose every day.
  
  
  RESULTS
  The protocol was applied to 105 milk-allergic children diagnosed by specific IgE to milk and controlled oral food challenge. The mean duration of the induction phase was 19 weeks. Of the 105 subjects, 86 (81.9%) successfully complied with the protocol and 19 (19.1%) failed. Causes of failure were moderate/severe reactions in 12 patients (12.44%) and personal reasons in 7 (6.66%). A total of 182 adverse reactions occurred during the induction phase, most of them mild. Baseline specific IgE to milk and casein was significantly lower (P < 0.05) in the successfully treated group compared to the group in which the treatment failed.
  
  
  CONCLUSIONS
  Milk oral immunotherapy is a safe and effective treatment for milk-allergic children, although adverse reactions may occur. Baseline milk and casein-specific IgE may be useful to predict a good response to milk oral immunotherapy.
authors.affiliation: Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain. ssanchez@salud.madrid.org
authors.forename: Silvia
authors.initials: S
authors.lastname: Sánchez-García
authors.forename: Pablo
authors.initials: P
authors.lastname: Rodríguez del Río
authors.forename: Carmelo
authors.initials: C
authors.lastname: Escudero
authors.forename: Cristina
authors.initials: C
authors.lastname: García-Fernández
authors.forename: Antonio
authors.initials: A
authors.lastname: Ramirez
authors.forename: M Dolores
authors.initials: MD
authors.lastname: Ibáñez
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000485:Allergens / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D016269:Milk Hypersensitivity / Q000276:immunology / Q000628:therapy*; D008894:Milk Proteins / Q000276:immunology; D011446:Prospective Studies; D012882:Skin Tests
chemical_list: D000485:Allergens; D008894:Milk Proteins