title: Safety and Efficacy of Low-Dose Oral Immunotherapy for Hen's Egg Allergy in Children.
abstract: BACKGROUND
  The minimal dose for oral immunotherapy (OIT) tolerance is unknown. We investigated the efficacy and safety of low-dose OIT with 1/32 of the volume of a whole egg.
  
  
  METHODS
  Thirty-three children (aged ≥5 years) with egg allergies confirmed by oral food challenge against 1/32 of a heated whole egg (194 mg of egg protein) were enrolled. The OIT group ingested a scrambled egg once a day. The volume was gradually increased up to a maximum of 1/32 of a heated whole egg. Egg consumption was completely absent in the control group.
  
  
  RESULTS
  There were no significant differences in background between the OIT and control groups. Respectively, 71% (15/21) and 0% (0/12) of the patients in the OIT and control groups exhibited sustained unresponsiveness to 1/32 of a whole egg 2 weeks after stopping OIT after 12 months (p < 0.001); 33% (7/21) and 0% (0/12; p = 0.032), respectively, showed sustained unresponsiveness to 1/2 of a whole egg. Egg white- or ovomucoid-specific IgE levels in the OIT group were significantly lower than at baseline after 12 months. Egg white- or ovomucoid-specific IgG as well as IgG4 levels in the OIT group were significantly higher than baseline levels after 1, 3, 6, and 12 months. Adverse allergic reactions were rare, and most symptoms were mild.
  
  
  CONCLUSIONS
  Low-dose OIT induced sustained unresponsiveness to 1/32 and 1/2 of a whole egg, with no severe symptoms. To improve food allergies, continuous intake of small amounts of these foods may be as effective as the consumption of larger quantities.
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Yanagida
authors.forename: Sakura
authors.initials: S
authors.lastname: Sato
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Asaumi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nagakura
authors.forename: Kiyotake
authors.initials: K
authors.lastname: Ogura
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ebisawa
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology*; D000818:Animals; D002648:Child; 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 / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008297:Male
chemical_list: D000485:Allergens; D007074:Immunoglobulin G; D007073:Immunoglobulin E