title: Randomized controlled trial of oral immunotherapy for egg allergy in Japanese patients.
abstract: BACKGROUND
  Egg allergy is one of the most common food allergies in young children. While oral immunotherapy (OIT) is not routinely recommended in current guidelines, it has been considered as a potential alternative treatment strategy. Studies on OIT for food allergy have been explored, but no controlled trials have been reported in Japan.
  
  
  METHODS
  The first oral food challenge (OFC) was performed before treatment to ensure diagnosis and evaluate the threshold dose for egg using the double-blind, placebo-controlled food challenge. Participants were randomly assigned by computerized algorithm to receive OIT using egg (OIT group) or no egg (egg elimination [EE] group). A second OFC was performed in both groups approximately 6 months after therapy. Blood samples were collected and egg white-specific immunoglobulin (Ig)E and IgG4 were measured before and after the treatment period.
  
  
  RESULTS
  Eight of the 14 patients (57%) in the OIT group had no allergic reaction to 4 g dry egg powder whereas none of the 16 patients in the EE group did. All 14 patients in the OIT group had increased threshold for egg powder in the second OFC compared with baseline. There was no significant change in egg white-specific IgE level during therapy. After therapy, egg white-specific IgG4 increased significantly in the OIT group, but not in the EE group.
  
  
  CONCLUSIONS
  OIT is effective in increasing the threshold for allergens and inducing desensitization in Japanese egg allergy patients, similarly to North American and European patients.
authors.affiliation: Department of Pediatrics, Saitama City Hospital, Saitama, Japan.|Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Akashi
authors.affiliation: Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.|Department of Pediatrics, Tokyo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yasudo
authors.affiliation: Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Narita
authors.affiliation: Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nomura
authors.affiliation: Division of Allergy, Department of Internal Physical Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Akasawa
authors.affiliation: Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ebisawa
authors.affiliation: Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Ohya
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods*; D004311:Double-Blind Method; D021181:Egg Hypersensitivity / Q000276:immunology / Q000628:therapy*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D016896:Treatment Outcome
keywords: children; egg allergy; immunoglobulin G4; oral immunotherapy; randomized controlled trial