title: Oral immunotherapy with low allergenic hydrolysed egg in egg allergic children.
abstract: A major drawback of oral immunotherapy for food allergy is the possibility of severe side-effects. We assessed both safety and efficacy of a low allergenic hydrolysed egg (HydE) preparation used in a double-blind placebo-controlled randomized study in egg allergic children.
  
  
  
  In a pilot multicentre study, 29 egg allergic patients (aged 1-5.5 years) were administered daily for 6 months 9 g HydE or placebo in a blinded, randomized manner. Safety was verified by oral food challenge to assess tolerance towards HydE at the start and efficacy by an open oral food challenge (OFC, primary outcome) at the end. Additionally, changes in basophil activation and specific IgE and IgG4 were assessed.
  
  
  
  All egg allergic patients randomized to HydE (n = 15) tolerated the full dose at day 1 and received the maintenance dose from the start at home. No statistically significant difference was observed on the final OFC (36% and 21% had a negative OFC in the treatment and placebo groups, respectively). Specific IgG4 levels increased, while both CD203c+ and CD63+ basophils decreased significantly more over time in the treatment than in the placebo group.
  
  
  
  HydE can be regarded as a safe, low allergenic product to use in children allergic to egg. Although not significant, HydE given for 6 months increased numerically the proportion of patients becoming tolerant to egg. HydE induced a modulation of the immune response towards better tolerance. A longer treatment period and/or a higher dose may improve the clinical outcome and should be evaluated.
authors.affiliation: Allergy Department, 2nd Paediatric Clinic, University of Athens, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Giavi
authors.affiliation: Allergy Group, Nutrition & Health Research, Nestlé Research Center, Lausanne, Switzerland.
authors.forename: Y M
authors.initials: YM
authors.lastname: Vissers
authors.affiliation: Referral Centre for Food Allergy Diagnosis and Treatment, Veneto Region, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Muraro
authors.affiliation: Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland.|CK-CARE, Davos, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Lauener
authors.affiliation: Allergy Department, 2nd Paediatric Clinic, University of Athens, Athens, Greece.
authors.forename: A P
authors.initials: AP
authors.lastname: Konstantinopoulos
authors.affiliation: Allergy Group, Nutrition & Health Research, Nestlé Research Center, Lausanne, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Mercenier
authors.affiliation: Allergy Group, Nutrition & Health Research, Nestlé Research Center, Lausanne, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Wermeille
authors.affiliation: Referral Centre for Food Allergy Diagnosis and Treatment, Veneto Region, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Lazzarotto
authors.affiliation: Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.|Christine Kühne-Center for Allergy Research and Education, Zurich, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Frei
authors.affiliation: Referral Centre for Food Allergy Diagnosis and Treatment, Veneto Region, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Bonaguro
authors.affiliation: CK-CARE, Davos, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Summermatter
authors.affiliation: Allergy Group, Nutrition & Health Research, Nestlé Research Center, Lausanne, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Nutten
authors.affiliation: Allergy Department, 2nd Paediatric Clinic, University of Athens, Athens, Greece. Nikolaos.Papadopoulos@manchester.ac.uk.|Centre for Paediatrics & Child Health, Institute of Human Development, The University of Manchester, Manchester, UK. Nikolaos.Papadopoulos@manchester.ac.uk.
authors.forename: N G
authors.initials: NG
authors.lastname: Papadopoulos
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000008:administration & dosage* / Q000276:immunology*; D001491:Basophils / Q000276:immunology / Q000378:metabolism; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods; D021181:Egg Hypersensitivity / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D004531:Eggs / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D016130:Immunophenotyping; D007223:Infant; D008297:Male; D010727:Phosphoric Diester Hydrolases / Q000378:metabolism; D011755:Pyrophosphatases / Q000378:metabolism; D012882:Skin Tests; D060149:Tetraspanin 30 / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000485:Allergens; C427944:ENPP3 protein, human; D007074:Immunoglobulin G; D060149:Tetraspanin 30; D007073:Immunoglobulin E; D010727:Phosphoric Diester Hydrolases; D011755:Pyrophosphatases
keywords: basophil activation test; egg; food allergy; hydrolysed proteins; oral immunotherapy