title: The oral food desensitization in the Italian allergy centres.
abstract: BACKGROUND
  Attempts aimed at inducing food tolerance through oral food desensitization (OFD) for the treatment of IgE-mediated food allergies are increasing. In Italy, a number of allergy centres offer this procedure.
  
  
  OBJECTIVE
  To collect information on how these centres are organized, how patients are selected, the methods used to administer OFD and how adverse reactions are managed.
  
  
  METHODS
  A questionnaire was e-mailed to all the Italian allergy centres offering OFD.
  
  
  RESULTS
  The survey shows a high degree of variability between centres. A correct diagnosis of food allergy is crucial for selecting patients for OFD. In the Italian allergy centres, oral food challenges are mostly open label (84%), but in 16% of cases they are single-blind (8%) or double-blind (8%). A high proportion of allergy centres (83%) offer OFD to children presenting forms of anaphylaxis triggered by traces--or very low doses--of food allergen. The majority of allergy centres (76%) enroll patients over 3 years of age, with 44% enrolling patients above the age of 5. Not-controlled asthma, unreliability of parents in the management of OFD and/or risk of adverse events, are the main reasons for exclusion from the procedure.
  
  
  CONCLUSIONS
  Although OFD may sometimes be successful and may be considered a valid alternative to an elimination diet, further randomized controlled trials are needed, in order to clarify some controversial points, such as the characteristics of the child undergoing OFD, and the methods of food preparation and administration. Moreover, further studies should further investigate OFD safety, efficacy and costs.
authors.affiliation: Primary Care Pediatrics, Rome, Italy. E-mail: paolo.meglio@tiscali.it.
authors.forename: P
authors.initials: P
authors.lastname: Meglio
authors.affiliation: Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Caminiti
authors.affiliation: Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: G B
authors.initials: GB
authors.lastname: Pajno
authors.affiliation: Pediatric Department, Fatebenefratelli Hospital, Benevento, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Dello Iacono
authors.affiliation: Pediatric Department and Pediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Tripodi
authors.affiliation: Primary Care Pediatrics, Salerno, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Verga
authors.affiliation: Pediatric Department, Garbagnate Santa Corona Hospital, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Martelli
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D005512:Food Hypersensitivity / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007159:Immunologic Tests; D007223:Infant; D020407:Internet; D007558:Italy; D010818:Practice Patterns, Physicians' / Q000639:trends; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D015415:Biomarkers; D007073:Immunoglobulin E
keywords: Cow’s milk allergy; Egg allergy; Food allergy; Food tolerance; Hen’s egg allergy; Immunotherapy safety; Oral food desensitization; Oral immunotherapy; Specific oral tolerance induction; Sublingual oral food desensitization