Rush Specific Oral Tolerance Induction in School-Age Children with Severe Egg Allergy: One Year Follow Up
Rush Specific Oral Tolerance Induction in School-Age Children with Severe Egg Allergy: One Year Follow Up
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DOI：
10.2332/allergolint.09-oa-0107
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发表时间：
2010-03-01
影响因子：
6.8
通讯作者：
Kurihara, Kazuyuki
中科院分区：
文献类型：
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作者：
Itoh, Naoka;Itagaki, Yasuharu;Kurihara, Kazuyuki
背景：目前，食物过敏的唯一治疗方法是避免食用致敏食物。已经进行了一些特异性口服耐受诱导（SOTI）的试验，但尽管治疗时间较长，至少3个月至数年，但耐受诱导率仍较低。长期以来，人们一直希望有一种新的治疗方法。本研究的目的是对学龄期严重鸡蛋过敏患者进行快速SOTI治疗，并评估该方法的安全性和有效性。方法：6名学龄儿童经双盲、安慰剂对照食物激发试验（DBPCFC）证实的重度IgE介导的鸡蛋过敏患者（7-12岁）接受了快速SOTI，患者每天多次摄入剂量递增的鸡蛋。结果：在DBPCFC中，鸡蛋白色致敏的中位阈值剂量为0.152 g（0.012-0.360 g）。所有受试者获得了对超过一个全蛋（60 g）的耐受性。仅用了12天（9-18天）。没有人出现任何严重反应。我们观察到，在血液中快速SOTI后6个月，IL-10减少，TGF-β 1增加，12个月时，鸡蛋特异性IgE减少，蛋清特异性IgG增加（4）。所有受试者已经能够摄入一个以上的全蛋everysince.Conclusions：我们的匆忙SOTI是一种安全有效的治疗严重的食物过敏，因为只需要几个星期获得耐受性。它将取代过敏原回避作为食物过敏的治疗方法。
Background: At present, the only treatment for food allergy is to avoid the allergy-causing food. Some trials of specific oral tolerance induction (SOTI) have been carried out, but the rate of tolerance induction was low despite long treatment periods, at least 3 months to several years. A new type of treatment is long desired. The objectives of this study are to perform our rush SOTI for school-age patients with severe egg allergy, and to evaluate the safety and efficacy of this method for one year.Methods: Six school-age children (7-12 years of age) with severe IgE-mediated egg allergy confirmed by double-blind, placebo-controlled food challenge (DBPCFC) underwent rush SOTI, in which patients ingested increasing doses of egg several times every day. After rush SOTI, patients ingested the maintenance dose of egg at least twice a week.Results: In DBPCFC, the median threshold dose of egg white inducing allergic reactions was 0.152 g (0.012-0.360 g). All subjects acquired tolerance to more than one whole egg (60 g). It took only 12 days (9-18 days). None experienced any serious reaction. We observed a decrease in IL-10 and an increase in TGF-beta 1 at 6 months and a decrease in egg-specific IgE and an increase in egg white-specific IgG(4) at 12 months after rush SOTI in blood. All subjects have been able to ingest more than one whole egg ever since.Conclusions: Our rush SOTI is a safe and effective treatment for severe food allergy since only a few weeks are needed to acquire tolerance. It would replace allergen avoidance as the treatment for food allergy.