Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?

Eleonora Nucera; Anna Giulia Ricci; Angela Rizzi; Simona Mezzacappa; Alessia Di Rienzo; Valentina Pecora; Giampiero Patriarca; Alessandro Buonomo; Arianna Aruanno; Domenico Schiavino

doi:10.5114/ada.2018.77671

eISSN: 2299-0046
ISSN: 1642-395X

Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii

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4/2018
vol. 35

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Original paper

Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?

Eleonora Nucera

,

Anna Giulia Ricci

,

Angela Rizzi

,

Simona Mezzacappa

,

Alessia Di Rienzo

,

Valentina Pecora

,

Giampiero Patriarca

,

Alessandro Buonomo

,

Arianna Aruanno

,

Domenico Schiavino

Adv Dermatol Allergol 2018; XXXV (4): 392–396

DOI: https://doi.org/10.5114/ada.2018.77671

Online publish date: 2018/08/21

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AMA

Nucera E, Ricci A, Rizzi A, et al. Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2018;35(4):392-396. doi:10.5114/ada.2018.77671.

APA

Nucera, E., Ricci, A., Rizzi, A., Mezzacappa, S., Rienzo, A.,  & Pecora, V. et al. (2018). Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 35(4), 392-396. https://doi.org/10.5114/ada.2018.77671

Chicago

Nucera, Eleonora, Anna Giulia Ricci, Angela Rizzi, Simona Mezzacappa, Alessia Di Rienzo, Valentina Pecora,  and Giampiero Patriarca et al. 2018. "Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 35 (4): 392-396. doi:10.5114/ada.2018.77671.

Harvard

Nucera, E., Ricci, A., Rizzi, A., Mezzacappa, S., Rienzo, A., Pecora, V., Patriarca, G., Buonomo, A., Aruanno, A.,  and Schiavino, D. (2018). Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 35(4), pp.392-396. https://doi.org/10.5114/ada.2018.77671

MLA

Nucera, Eleonora et al. "Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 35, no. 4, 2018, pp. 392-396. doi:10.5114/ada.2018.77671.

Vancouver

Nucera E, Ricci A, Rizzi A, Mezzacappa S, Rienzo A, Pecora V et al. Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2018;35(4):392-396. doi:10.5114/ada.2018.77671.

Introduction
The first therapeutic choice for food allergy is avoidance of the responsible food, but when this approach is not possible, specific oral desensitization could be considered as a good alternative. It is not clear yet whether the acquired tolerance is transient or persistent.

Aim
We report on a subset of 13 patients of a larger study, treated successfully with specific oral tolerance induction who experienced secondary loss of tolerance after a period of allergen avoidance.

Material and methods
Thirteen patients affected by IgE-mediated food allergy: to cow milk (3 patients), to hen egg (3 patients), to cod fish (2 patients), to peanuts (1 patient) and to corn (1 patient) confirmed by a complete allergological workup and a double-blind placebo-controlled food challenge (DBPCFC), were treated with sublingual-oral desensitization. After the interruption of the maintenance phase, the laboratory tests were performed and 12 of 13 patients underwent DBPCFC.

Results
Oral specific desensitization was completed successfully in all the 13 reported patients. At different times after the end of treatment, they decided, on their own initiative, to stop the ingestion of incriminated food. A new food allergen re-exposure caused adverse reactions in 12 of 13 patients. The detection of specific IgE and IgG4 during the period of allergen avoidanceshowed an increase in or a stable level of specific IgE and a decrease in specific IgG4 in 8 patients.

Conclusions
According to our experience, the tolerance obtained through the desensitizing treatment is transient and so the regular allergen intake is necessary for its maintenance.

keywords:

Specific oral immunotherapy in food allergic patients: transient or persistent tolerance?

Eleonora Nucera , Anna Giulia Ricci , Angela Rizzi , Simona Mezzacappa , Alessia Di Rienzo , Valentina Pecora , Giampiero Patriarca , Alessandro Buonomo , Arianna Aruanno , Domenico Schiavino

food allergy, oral specific desensitization, follow-up, allergen avoidance, loss of tolerance, maintenance phase

Eleonora Nucera

,

Anna Giulia Ricci

,

Angela Rizzi

,

Simona Mezzacappa

,

Alessia Di Rienzo

,

Valentina Pecora

,

Giampiero Patriarca

,

Alessandro Buonomo

,

Arianna Aruanno

,

Domenico Schiavino