title: Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: a randomized controlled trial.
abstract: BACKGROUND
  Treatment of severe egg allergy is avoidance of hen's egg (HE) and carrying self-injectable epinephrine. Specific oral tolerance induction (SOTI) seems a promising alternative treatment. However, some aspects of SOTI are still considered experimental.
  
  
  METHODS
  We evaluated the efficacy and safety of an original 6-month SOTI protocol in children with very severe HE allergy using raw HE emulsion. Twenty children (age range: 5-11 yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6 months later. Control children were kept on an egg-free diet for 6 months and then underwent a second challenge.
  
  
  RESULTS
  After 6 months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10 ml, but <40 ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5 ml (no tolerance). After 6 months, nine control children tested positive to the second challenge at a dose ≤0.9 ml of raw HE emulsion, and one reacted to 1.8 ml (SOTI vs. control group p<0.0001). All children in the SOTI group had side effects, but no child had a grade 5 reaction according to the Sampson grading.
  
  
  CONCLUSIONS
  Six months of SOTI with raw HE emulsion resulted in partial tolerance, with regular intake, in a significant percentage of children with severe egg allergy.
authors.affiliation: Department of Paediatrics, Fatebenefratelli Hospital, Benevento, Italy.
authors.forename: Iride
authors.initials: I
authors.lastname: Dello Iacono
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tripodi
authors.forename: Mauro
authors.initials: M
authors.lastname: Calvani
authors.forename: Valentina
authors.initials: V
authors.lastname: Panetta
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Verga
authors.forename: Stefano
authors.initials: S
authors.lastname: Miceli Sopo
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D000707:Anaphylaxis / Q000276:immunology / Q000517:prevention & control*; D000818:Animals; D002645:Chickens; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000009:adverse effects* / Q000379:methods*; D004311:Double-Blind Method; D021181:Egg Hypersensitivity / Q000276:immunology / Q000517:prevention & control*; D004531:Eggs / Q000009:adverse effects*; D004655:Emulsions / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D012882:Skin Tests; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D004655:Emulsions; D007073:Immunoglobulin E