Skip to main content

Advertisement

Log in

Oral and Sublingual Immunotherapy for Treatment of IgE-Mediated Food Allergy

  • Published:
Clinical Reviews in Allergy & Immunology Aims and scope Submit manuscript

Abstract

Development of active therapies for IgE-mediated food allergy is a critical action step toward alleviating the adverse medical, psychosocial, and economic burdens on affected patients and families. Significant progress has been observed specifically in the application of single-allergen oral and sublingual immunotherapy for treatment of IgE-mediated food allergy, with emphasis on milk, egg, and peanut as the primary allergens. Oral immunotherapy (OIT) has demonstrated efficacy in promoting immunomodulatory effects that lead to the clinical outcome of desensitization, defined as reduced reactivity while on active OIT, in the majority of treated individuals; however, achievement of sustained unresponsiveness following cessation of therapy has been observed in a smaller subset of treated subjects. The potential therapeutic benefits of OIT must be carefully considered in light of the significant potential for adverse events ranging from self-limited or easily treated oropharyngeal, respiratory or gastrointestinal symptoms, to persistent abdominal complaints that lead to cessation of therapy in an estimated 10–15% of treated individuals. To date, the majority of studies have focused on single-allergen OIT approaches; however, multi-allergen OIT has shown promise in initial trials and is the subject of ongoing investigation to address the complex needs of multi-food allergic individuals. Sublingual immunotherapy (SLIT) has been utilized for the treatment of food allergy and pollen-food allergy syndrome, demonstrating moderate efficacy, a favorable safety profile and variable tolerability, with oropharyngeal symptoms most commonly observed. Although studies directly comparing OIT and SLIT are limited, in general, the favorable safety profile associated with SLIT comes at the expense of reduced efficacy, while the more robust clinical effects observed with OIT come at the risk of potentially intolerable, treatment-limiting side effects. Future investigation to address specific knowledge gaps including optimal dose, duration, age of initiation, maintenance schedule, mechanisms, predictors of risk and therapeutic response will be important to maximize efficacy, minimize risk and develop personalized, effective approaches to targeting food allergy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA et al (2010) Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 126(6 Suppl):S1–58

    PubMed  PubMed Central  Google Scholar 

  2. Stallings VA, Oria MP. Finding a path to safety in food allergy: assessment of the global burden, causes, prevention, management, and public policy: the National Academies Press; 2016 2016. 576 p

  3. Sicherer SH, Vargas PA, Groetch ME, Christie L, Carlisle SK, Noone S, Jones SM (2012) Development and validation of educational materials for food allergy. J Pediatr 160(4):651–656

    Article  Google Scholar 

  4. Jones SM, Burks AW (2017) Food Allergy. N Engl J Med 377(12):1168–1176

    Article  Google Scholar 

  5. Wood RA (2016) Food allergen immunotherapy: current status and prospects for the future. J Allergy Clin Immunol 137(4):973–982

    Article  CAS  Google Scholar 

  6. Tordesillas L, Berin MC, Sampson HA (2017) Immunology of food allergy. Immunity 47(1):32–50

    Article  CAS  Google Scholar 

  7. Vickery BP, Scurlock AM, Jones SM, Burks AW (2011) Mechanisms of immune tolerance relevant to food allergy. J Allergy Clin Immunol 127(3):576–584 quiz 85-6

    Article  CAS  Google Scholar 

  8. Jones SM, Burks AW, Dupont C (2014) State of the art on food allergen immunotherapy: oral, sublingual, and epicutaneous. J Allergy Clin Immunol 133(2):318–323

    Article  CAS  Google Scholar 

  9. Jones S, Burks A, Wood R, Fleischer D, Sicherer S, Henning A et al (2014) Long-lasting egg consumption in egg allergic children treated with oral immunotherapy (OIT): follow-up from the Consortium of Food Allergy Research (CoFAR) study. J Allergy Clin Immunol 133:AB403

    Article  Google Scholar 

  10. Vickery BP, Scurlock AM, Kulis M, Steele PH, Kamilaris J, Berglund JP, Burk C, Hiegel A, Carlisle S, Christie L, Perry TT, Pesek RD, Sheikh S, Virkud Y, Smith PB, Shamji MH, Durham SR, Jones SM, Burks AW (2014) Sustained unresponsiveness to peanut in subjects who have completed peanut oral immunotherapy. J Allergy Clin Immunol 133(2):468–475

    Article  CAS  Google Scholar 

  11. Berin MC, Shreffler WG (2016) Mechanisms underlying induction of tolerance to foods. Immunol Allergy Clin N Am 36(1):87–102

    Article  Google Scholar 

  12. Jones SM, Pons L, Roberts JL, Scurlock AM, Perry TT, Kulis M, Shreffler WG, Steele P, Henry KA, Adair M, Francis JM, Durham S, Vickery BP, Zhong X, Burks AW (2009) Clinical efficacy and immune regulation with peanut oral immunotherapy. J Allergy Clin Immunol 124(2):292–300

    Article  CAS  Google Scholar 

  13. Burks AW, Jones SM, Wood RA, Fleischer DM, Sicherer SH, Lindblad RW, Stablein D, Henning AK, Vickery BP, Liu AH, Scurlock AM, Shreffler WG, Plaut M, Sampson HA, Consortium of Food Allergy Research (CoFAR) (2012) Oral immunotherapy for treatment of egg allergy in children. N Engl J Med 367(3):233–243

    Article  CAS  Google Scholar 

  14. Gorelik M, Narisety SD, Guerrerio AL, Chichester KL, Keet CA, Bieneman AP, Hamilton RG, Wood RA, Schroeder JT, Frischmeyer-Guerrerio PA (2015) Suppression of the immunologic response to peanut during immunotherapy is often transient. J Allergy Clin Immunol 135(5):1283–1292

    Article  CAS  Google Scholar 

  15. Thyagarajan A, Jones SM, Calatroni A, Pons L, Kulis M, Woo CS, Kamalakannan M, Vickery BP, Scurlock AM, Wesley Burks A, Shreffler WG (2012) Evidence of pathway-specific basophil anergy induced by peanut oral immunotherapy in peanut-allergic children. Clin Exp Allergy 42(8):1197–1205

    Article  CAS  Google Scholar 

  16. Vickery BP, Lin J, Kulis M, Fu Z, Steele PH, Jones SM et al (2013) Peanut oral immunotherapy modifies IgE and IgG4 responses to major peanut allergens. J Allergy Clinl Immunol 131(1):128–134 e1–3

    Article  CAS  Google Scholar 

  17. Syed A, Garcia MA, Lyu S-C, Bucayu R, Kohli A, Ishida S et al (2014) Peanut oral immunotherapy results in increased antigen-induced regulatory T-cell function and hypomethylation of forkhead box protein 3 (FOXP3). J Allergy Clin Immunol 133(2):500–10.e11

    Article  CAS  Google Scholar 

  18. Wright BL, Kulis M, Orgel KA, Burks AW, Dawson P, Henning AK, Jones SM, Wood RA, Sicherer SH, Lindblad RW, Stablein D, Leung DYM, Vickery BP, Sampson HA, the Consortium of Food Allergy Research (2016) Component-resolved analysis of IgA, IgE, and IgG4 during egg OIT identifies markers associated with sustained unresponsiveness. Allergy 71(11):1552–1560

    Article  CAS  Google Scholar 

  19. Wambre E, Bajzik V, DeLong JH, O'Brien K, Nguyen QA, Speake C et al (2017) A phenotypically and functionally distinct human TH2 cell subpopulation is associated with allergic disorders. Sci Transl Med 9(401):eaam9171

    Article  Google Scholar 

  20. Ryan JF, Hovde R, Glanville J, Lyu SC, Ji X, Gupta S, Tibshirani RJ, Jay DC, Boyd SD, Chinthrajah RS, Davis MM, Galli SJ, Maecker HT, Nadeau KC (2016) Successful immunotherapy induces previously unidentified allergen-specific CD4+ T-cell subsets. Proc Natl Acad Sci U S A 113(9):E1286–E1295

    Article  CAS  Google Scholar 

  21. Anagnostou K, Islam S, King Y, Foley L, Pasea L, Bond S, Palmer C, Deighton J, Ewan P, Clark A (2014) Assessing the efficacy of oral immunotherapy for the desensitisation of peanut allergy in children (STOP II): a phase 2 randomised controlled trial. Lancet 383(9925):1297–1304

    Article  CAS  Google Scholar 

  22. Blumchen K, Ulbricht H, Staden U, Dobberstein K, Beschorner J, de Oliveira LCL, et al. Oral peanut immunotherapy in children with peanut anaphylaxis J Allergy Clin Immunol. In Press, Corrected Proof

  23. Keet CA, Seopaul S, Knorr S, Narisety S, Skripak J, Wood RA (2013) Long-term follow-up of oral immunotherapy for cow’s milk allergy. J Allergy Clin Immunol 132(3):737–739 e6

    Article  Google Scholar 

  24. Skripak JM, Nash SD, Rowley H, Brereton NH, Oh S, Hamilton RG, Matsui EC, Burks AW, Wood RA (2008) A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow's milk allergy. J Allergy Clin Immunol 122(6):1154–1160

    Article  CAS  Google Scholar 

  25. Varshney P, Jones SM, Scurlock AM, Perry TT, Kemper A, Steele P, Hiegel A, Kamilaris J, Carlisle S, Yue X, Kulis M, Pons L, Vickery B, Burks AW (2011) A randomized controlled study of peanut oral immunotherapy: clinical desensitization and modulation of the allergic response. J Allergy Clin Immunol 127(3):654–660

    Article  CAS  Google Scholar 

  26. Berglund JP, Szczepanski N, Penumarti A, Beavers A, Kesselring J, Orgel K, Burnett B, Burks AW, Kulis M (2017) Preparation and analysis of peanut flour used in oral immunotherapy clinical trials. J Allergy Clin Immunol Pract 5(4):1098–1104

    Article  Google Scholar 

  27. Filep S, Block DS, Smith BRE, King EM, Commins S, Kulis M et al (2017) Specific allergen profiles of peanut foods and diagnostic or therapeutic allergenic products. J Allergy Clin Immunol

  28. Keet CA, Frischmeyer-Guerrerio PA, Thyagarajan A, Schroeder JT, Hamilton RG, Boden S, Steele P, Driggers S, Burks AW, Wood RA (2012) The safety and efficacy of sublingual and oral immunotherapy for milk allergy. J Allergy Clin Immunol 129(2):448–455

    Article  CAS  Google Scholar 

  29. Narisety SD, Frischmeyer-Guerrerio PA, Keet CA, Gorelik M, Schroeder J, Hamilton RG et al (2015) A randomized, double-blind, placebo-controlled pilot study of sublingual versus oral immunotherapy for the treatment of peanut allergy. J Allergy Clin Immunol 135(5):1275–82.e6

    Article  CAS  Google Scholar 

  30. Clark ATIS, King Y, Deighton J, Anagnostou K, Ewan PW (2009) Successful oral tolerance induction in severe peanut allergy. Allergy 64(8):1218–1220

    Article  CAS  Google Scholar 

  31. Longo G, Barbi E, Berti I, Meneghetti R, Pittalis A, Ronfani L, Ventura A (2008) Specific oral tolerance induction in children with very severe cow's milk-induced reactions. J Allergy Clin Immunol 121(2):343–347

    Article  CAS  Google Scholar 

  32. Meglio P, Bartone E, Plantamura M, Arabito E, Giampietro PG (2004) A protocol for oral desensitization in children with IgE-mediated cow’s milk allergy. Allergy 59:980–987

    Article  CAS  Google Scholar 

  33. Narisety SD, Skripak JM, Steele P, Hamilton RG, Matsui EC, Burks AW, Wood RA (2009) Open-label maintenance after milk oral immunotherapy for IgE-mediated cow’s milk allergy. J Allergy Clin Immunol 124(3):610–612

    Article  CAS  Google Scholar 

  34. Pajno GB, Caminiti L, Ruggeri P, De Luca R, Vita D, La Rosa M et al (2010) Oral immunotherapy for cow's milk allergy with a weekly up-dosing regimen: a randomized single-blind controlled study. Ann Allergy Asthma Immunol 105(5):376–381

    Article  CAS  Google Scholar 

  35. Wood RA, Kim JS, Lindblad R, Nadeau K, Henning AK, Dawson P, Plaut M, Sampson HA (2016) A randomized, double-blind, placebo-controlled study of omalizumab combined with oral immunotherapy for the treatment of cow’s milk allergy. J Allergy Clin Immunol 137(4):1103–1110 e11

    Article  CAS  Google Scholar 

  36. Buchanan AD, Green TD, Jones SM, Scurlock AM, Christie L, Althage KA, Steele PH, Pons L, Helm RM, Lee LA, Burks AW (2007) Egg oral immunotherapy in nonanaphylactic children with egg allergy. J Allergy Clin Immunol 119(1):199–205

    Article  CAS  Google Scholar 

  37. Vickery BP, Pons L, Kulis M, Steele P, Jones SM, Burks AW (2010) Individualized IgE-based dosing of egg oral immunotherapy and the development of tolerance. Ann Allergy Asthma Immunol 105(6):444–450

    Article  CAS  Google Scholar 

  38. Sato S, Utsunomiya T, Imai T, Yanagida N, Asaumi T, Ogura K et al (2015) Wheat oral immunotherapy for wheat-induced anaphylaxis. J Allergy Clin Immunol 136(4):1131–3.e7

    Article  Google Scholar 

  39. Bégin P, Winterroth LC, Dominguez T, Wilson SP, Bacal L, Mehrotra A et al (2014) Safety and feasibility of oral immunotherapy to multiple allergens for food allergy. Allergy Asthma Clin Immunol 10(1):1

    Article  Google Scholar 

  40. Brozek TL, Hsu J, Kries J, Compalati E, Santesso N, Fiocchi A, Schunemann HJ (2012) Oral immuotherapy for IgE-mediated cow’s milk allergy: a systematic review and meta-analysis. Clin Exp Allergy 42(3):363–374

    Article  CAS  Google Scholar 

  41. Yeung JPKL, McDevitt J, Ben-Shoshan M, Alizadehfar R (2012) Oral immunotherapy for milk allergy. Cochrane Database Syst Rev 11:CD009542

    PubMed  Google Scholar 

  42. Nurmatov U, Devereux G, Worth A, Healy L, Sheikh A (2013) Effectiveness and safety of orally administered immunotherapy for food allergies: a systematic review and meta-analysis. Br J Nutr 111(1):12–22

    Article  Google Scholar 

  43. Nurmatov U, Dhami S, Arasi S, Pajno GB, Fernandez-Rivas M, Muraro A, Roberts G, Akdis C, Alvaro-Lozano M, Beyer K, Bindslev-Jensen C, Burks W, du Toit G, Ebisawa M, Eigenmann P, Knol E, Makela M, Nadeau KC, O'Mahony L, Papadopoulos N, Poulsen LK, Sackesen C, Sampson H, Santos AF, van Ree R, Timmermans F, Sheikh A (2017) Allergen immunotherapy for IgE-mediated food allergy: a systematic review and meta-analysis. Allergy 72(8):1133–1147

    Article  CAS  Google Scholar 

  44. Oppenheimer JJ, Nelson HS, Bock SA, Christensen F, Leung DY (1992) Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol 90(2):256–262

    Article  CAS  Google Scholar 

  45. Nelson HS, Lahr J, Rule R, Bock A, Leung D (1997) Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. J Allergy Clin Immunol 99(6 Pt 1):744–751

    Article  CAS  Google Scholar 

  46. Hofmann AM, Scurlock AM, Jones SM, Palmer KP, Lokhnygina Y, Steele PH, Kamilaris J, Burks AW (2009) Safety of a peanut oral immunotherapy protocol in children with peanut allergy. J Allergy Clin Immunol 124(2):286–291

    Article  CAS  Google Scholar 

  47. Vázquez-Ortiz M, Alvaro-Lozano M, Alsina L, Garcia-Paba MB, Piquer-Gibert M, Giner-Muñoz MT, Lozano J, Domínguez-Sánchez O, Jiménez R, Días M, Martín-Mateos MA, Plaza-Martín AM (2013) Safety and predictors of adverse events during oral immunotherapy for milk allergy: severity of reaction at oral challenge, specific IgE and prick test. Clin Exp Allergy 43(1):92–102

    Article  Google Scholar 

  48. Vickery BPSA, Steele PH, Kamilaris J, Hiegel AM, Carlisle SK, Perry TT, Jones SM, Burks AW (2011) Early and persistent gastrointestinal side Effects predict withdrawal from peanut oral immunotherapy (OIT) [abstract]. J Allergy Clin Immunol 126:AB87

    Google Scholar 

  49. Sánchez-García S, Rodríguez del Río P, Escudero C, Martínez-Gómez MJ, Ibáñez MD (2012) Possible eosinophilic esophagitis induced by milk oral immunotherapy. J Allergy Clin Immunol 129(4):1155–1157

    Article  Google Scholar 

  50. Ridolo E, De Angelis GL, Dall'Aglio P (2011) Eosinophilic esophagitis after specific oral tolerance induction for egg protein. Ann Allergy Asthma Immunol 106(1):73–74

    Article  Google Scholar 

  51. Martorell A, De la Hoz B, Ibáñez MD, Bone J, Terrados MS, Michavila A, Plaza AM, Alonso E, Garde J, Nevot S, Echeverria L, Santana C, Cerdá JC, Escudero C, Guallar I, Piquer M, Zapatero L, Ferré L, Bracamonte T, Muriel A, Martínez MI, Félix R (2011) Oral desensitization as a useful treatment in 2-year-old children with cow's milk allergy. Clin Exper Allergy 41(9):1297–1304

    Article  CAS  Google Scholar 

  52. Virkud YV, Burks AW, Steele PH, Edwards LJ, Berglund JP, Jones SM, Scurlock AM, Perry TT, Pesek RD, Vickery BP (2017) Novel baseline predictors of adverse events during oral immunotherapy in children with peanut allergy. J Allergy Clin Immunol 139(3):882–888 e5

    Article  Google Scholar 

  53. Varshney P, Steele PH, Vickery BP, Bird JA, Thyagarajan A, Scurlock AM, Perry TT, Jones SM, Burks AW (2009) Adverse reactions during peanut oral immunotherapy home dosing. J Allergy Clin Immunol 124(6):1351–1352

    Article  Google Scholar 

  54. Wasserman RL, Factor JM, Baker JW, Mansfield LE, Katz Y, Hague AR et al (2014) Oral immunotherapy for peanut allergy: multipractice experience with epinephrine-treated reactions. J Allergy Clin Immunol 2(1):91–6.e2

    Article  Google Scholar 

  55. Staden U, Rolinck-Werninghaus C, Brewe F, Wahn U, Niggemann B, Beyer K (2007) Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction. Allergy 62:1261–1269

    Article  CAS  Google Scholar 

  56. Jones SM, Burks AW, Keet C, Vickery BP, Scurlock AM, Wood RA, Liu AH, Sicherer SH, Henning AK, Lindblad RW, Dawson P, Berin C, Fleischer DM, Leung DYM, Plaut M, Sampson HA, Consortium of Food Allergy Research (CoFAR) (2016) Long-term treatment with egg oral immunotherapy enhances sustained unresponsiveness that persists after cessation of therapy. J Allergy Clin Immunol 137(4):1117–1127 e10

    Article  CAS  Google Scholar 

  57. Rigbi NE, Goldberg MR, Levy MB, Nachshon L, Golobov K, Elizur A (2017) Changes in patient quality of life during oral immunotherapy for food allergy. Allergy 72:1883–1890

    Article  CAS  Google Scholar 

  58. Patriarca G, Nucera E, Pollastrini E, De Pasquale T, Lombardo C, Buonomo A et al (2006) Oral rush desensitization in peanut allergy: a case report. Dig Dis Sci 51(3):471–473

    Article  Google Scholar 

  59. Mansfield L (2006) Successful oral desensitization for systemic peanut allergy. Ann Allergy Asthma Immunol 97(2):266–267

    Article  Google Scholar 

  60. Anagnostou KCA, King Y, Islam S, Deighton J, Ewan P (2011) Efficacy and safety of high-dose peanut oral immunotherapy with factors predicting outcome. Clin Exp Allergy 41(9):1273–1281

    Article  CAS  Google Scholar 

  61. Vickery BP, Berglund JP, Burk CM, Fine JP, Kim EH, Kim JI, Keet CA, Kulis M, Orgel KG, Guo R, Steele PH, Virkud YV, Ye P, Wright BL, Wood RA, Burks AW (2017) Early oral immunotherapy in peanut-allergic preschool children is safe and highly effective. J Allergy Clin Immunol 139(1):173–181 e8

    Article  CAS  Google Scholar 

  62. Tang MLK, Ponsonby A-L, Orsini F, Tey D, Robinson M, Su EL et al (2015) Administration of a probiotic with peanut oral immunotherapy: a randomized trial. J Allergy Clin Immunol 135(3):737–44.e8

    Article  CAS  Google Scholar 

  63. Garvey AA, O'Sullivan D, Hourihane JO (2017) Home-based induction of sustained unresponsiveness in children with mild reactions to high doses of peanut. J Allergy Clin Immunol Pract 5:1757–1759

    Article  Google Scholar 

  64. Muraro A, Lemanske RF Jr, Castells M, Torres MJ, Khan D, Simon HU et al (2017) Precision medicine in allergic disease-food allergy, drug allergy, and anaphylaxis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology. Allergy 72(7):1006–1021

    Article  CAS  Google Scholar 

  65. Patriarca GSD, Nucera E, Schinco G, Milani A, Gasbarrini GB (1998) Food allergy in children: results of a standardized protocol for oral desensitization. Hepato-Gastroenterology 45(19):52–58

    CAS  PubMed  Google Scholar 

  66. Patriarca G, Nucera E, Roncallo C, Pollastrini E, Bartolozzi F, De Pasquale T et al (2003) Oral desensitizing treatment in food allergy: clinical and immunological results. Aliment Pharmacol Ther 17(3):459–465

    Article  CAS  Google Scholar 

  67. Morisset M, M-VD, Guenard L, Cuny JM, Frentz P, Hatahet R, Hanss CH, Beaudouin E, Petit N, Kanny G (2007) Oral desensitization in children with milk and egg allergies obtains recovery in a significant proportion of cases. A randomized study in 60 children with cow's milk allergy and 90 children with egg allergy. Eur Ann Allergy Clin Immunol 39(1):12–19

    CAS  Google Scholar 

  68. Meglio P, Giampietro PG, Carello R, Gabriele I, Avitabile S, Galli E (2013) Oral food desensitization in children with IgE-mediated hen's egg allergy: a new protocol with raw hen’s egg. Pediatr Allergy Immunol 24(1):75–83

    Article  Google Scholar 

  69. Itoh N, Itagaki Y, Kurihara K (2010) Rush specific oral tolerance induction in school-age children with severe egg allergy: one year follow up. Allergol Int 59(1):43–51

    Article  Google Scholar 

  70. Iacono D, Tripodi S, Calvani M, Panetta V, Verga MC, Miceli Sopo S (2013) Specific oral tolerance induction with raw hen’s egg in children with very severe egg allergy: a randomized controlled trial. Pediatr Allergy Immunol 24(1):66–74

    Article  Google Scholar 

  71. García Rodríguez RUJ, Feo-Brito F, Galindo PA, Borja J, Gómez E, Lara P, Guerra F (2011) Oral rush desensitization to egg: efficacy and safety. Clin Exp Allergy 41(9):1289–1296

    Article  Google Scholar 

  72. Jones SM (2016) Long-term treatment with egg oral immunotherapy enhances sustained unresponsiveness that persists after cessation of therapy. 137(4):1117–27.e10

  73. Meglio P, Bartone E, Plantamura M, Arabito E, Giampietro PG (2004) A protocol for oral desensitization in children with IgE-mediated cow’s milk allergy. Allergy 59:980–987

    Article  CAS  Google Scholar 

  74. Meglio PGP, Gianni S, Galli E (2008) Oral desensitization in children with immunoglobulin E-mediated cow's milk allergy—follow-up at 4 yr and 8 months. Pediatric allergy and immunology: official publication of the European society of. Pediatr Allergy Immunol 19(5):412–419

    Article  Google Scholar 

  75. Zapatero LAE, Fuentes V, Martínez MI (2008) Oral desensitization in children with cow’s milk allergy. J Investig Allergol Clin Immunol 18(5):389–396

    CAS  PubMed  Google Scholar 

  76. Álvaro M, Giner MT, Vázquez M, Lozano J, Domínguez O, Piquer M, Días M, Jiménez R, Martín MA, Alsina L, Plaza AM (2012) Specific oral desensitization in children with IgE-mediated cow’s milk allergy. Evolution in one year. Eur J Pediatr 171(9):1389–1395

    Article  Google Scholar 

  77. Sánchez-García S, Rodríguez del Río P, Escudero C, García-Fernández C, Ramirez A, Ibáñez MD (2012) Efficacy of oral immunotherapy protocol for specific oral tolerance induction in children with cow’s milk allergy. Isr Med Assoc J 14(1):43–47

    PubMed  Google Scholar 

  78. Rolinck-Werninghaus C, Staden U, Mehl A, Hamelmann E, Beyer K, Niggemann B (2005) Specific oral tolerance induction with food in children: transient or persistent effect on food allergy? Allergy 60(10):1320–1322

    Article  CAS  Google Scholar 

  79. Staden U, Rolinck-Werninghaus C, Brewe F, Wahn U, Niggemann B, Beyer K (2007) Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction. Allergy 62(11):1261–1269

    Article  CAS  Google Scholar 

  80. Longo G, Barbi E, Berti I, Meneghetti R, Pittalis A, Ronfani L, Ventura A (2008) Specific oral tolerance induction in children with very severe cow’s milk-induced reactions. J Allergy Clin Immunol 121(2):343–347

    Article  CAS  Google Scholar 

  81. Staden U, Blumchen K, Blankenstein N, Dannenberg N, Ulbricht H, Dobberstein K, Ziegert M, Niggemann B, Wahn U, Beyer K (2008) Rush oral immunotherapy in children with persistent cow’s milk allergy. J Allergy Clin Immunol 122(2):418–419

    Article  Google Scholar 

  82. Skripak JM, Nash SD, Rowley H, Brereton NH, Oh S, Hamilton RG et al (2008) A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow’s milk allergy. J Allergy Clin Immunol 122:1154–1160

    Article  CAS  Google Scholar 

  83. Pajno GBCL, Salzano G, Crisafulli G, Aversa T, Messina MF, Wasniewska M, Passalacqua G (2013) Comparison between two maintenance feeding regimens after successful cow’s milk oral desensitization. Pediatr Allergy Immunol 24(4):376–381

    Article  Google Scholar 

  84. Lemon-Mule H, Sampson HA, Sicherer SH, Shreffler WG, Noone S, Nowak-Wegrzyn A (2008) Immunologic changes in children with egg allergy ingesting extensively heated egg. J Allergy Clin Immunol 122(5):977–983

    Article  CAS  Google Scholar 

  85. Nowak-Wegrzyn A, Bloom KA, Sicherer SH, Shreffler WG, Noone S, Wanich N et al (2008) Tolerance to extensively heated milk in children with cow’s milk allergy. J Immunol 122(2):342–347 7 e1–2

    Google Scholar 

  86. Agyemang A, Feuille E, Tang J, Steinwandtner I, Sampson H, Nowak-Wegrzyn A (2017) Outcomes of 84 consecutive open food challenges to extensively heated (baked) milk in the allergy office. J Allergy Clin Immunol Pract

  87. Bégin P, Dominguez T, Wilson SP, Bacal L, Mehrotra A, Kausch B, Trela A, Tavassoli M, Hoyte E, O’Riordan G, Blakemore A, Seki S, Hamilton RG, Nadeau KC (2014) Phase 1 results of safety and tolerability in a rush oral immunotherapy protocol to multiple foods using Omalizumab. Allergy, Asthma Clin Immunol 10(1):7

    Article  Google Scholar 

  88. Otani IM, Bégin P, Kearney C, Dominguez TL, Mehrotra A, Bacal LR et al (2014) Multiple-allergen oral immunotherapy improves quality of life in caregivers of food-allergic pediatric subjects. Allergy, Asthma Clin Immunol 10(1):25

    Article  Google Scholar 

  89. Akdis CABI, Bahceciler N, Akdis M (2006) Immunological mechanisms of sublingual immunotherapy. Allergy 61(Suppl. 81):11–14

    Article  Google Scholar 

  90. Untersmayr E, Jensen-Jarolim E (2008) The role of protein digestibility and antacids on food allergy outcomes. J Allergy Clin Immunol 121(6):1301–1308

    Article  Google Scholar 

  91. Kim EH, Bird JA, Kulis M, Laubach S, Pons L, Shreffler W, Steele P, Kamilaris J, Vickery B, Burks AW (2011) Sublingual immunotherapy for peanut allergy: clinical and immunologic evidence of desensitization. J Allergy Clin Immunol 127(3):640–646

    Article  CAS  Google Scholar 

  92. Fleischer DM, Burks AW, Vickery BP, Scurlock AM, Wood RA, Jones SM et al (2013) Sublingual immunotherapy for peanut allergy: a randomized, double-blind, placebo-controlled multicenter trial, J allergy Clin Immunol. 131(1):119–127 e1–7

    Article  Google Scholar 

  93. Burks AW, Wood RA, Jones SM, Sicherer SH, Fleischer DM, Scurlock AM et al (2015) Sublingual immunotherapy for peanut allergy: long-term follow-up of a randomized multicenter trial. J Allergy Clin Immunol 135(5):1240–1248 e1–3

    Article  CAS  Google Scholar 

  94. Enrique E, Pineda F, Malek T, Bartra J, Basagaña M, Tella R et al (2005) Sublingual immunotherapy for hazelnut food allergy: a randomized, double-blind, placebo-controlled study with a standardized hazelnut extract. J Allergy Clin Immunol 116(5):1073–1079

    Article  CAS  Google Scholar 

  95. Fernandez-Rivas M, Garrido FS, Nadal JA, Diaz de Durana MD, Garcia BE, Gonzalez-Mancebo E et al (2009) Randomized double-blind, placebo-controlled trial of sublingual immunotherapy with a Pru p 3 quantified peach extract. Allergy 64(6):876–883

    Article  CAS  Google Scholar 

  96. Burk CM, Kulis M, Leung N, Kim EH, Burks AW, Vickery BP (2016) Utility of component analyses in subjects undergoing sublingual immunotherapy for peanut allergy. Clin Exp Allergy 46(2):347–353

    Article  CAS  Google Scholar 

  97. Kinaciyan T, Nagl B, Faustmann S, Frommlet F, Kopp S, Wolkersdorfer M, Wöhrl S, Bastl K, Huber H, Berger U, Bohle B (2017) Efficacy and safety of 4 months of sublingual immunotherapy with recombinant Mal d 1 and Bet v 1 in patients with birch pollen-related apple allergy. J Allergy Clin Immunol

  98. Chin SJ, Vickery BP, Kulis MD, Kim EH, Varshney P, Steele P, Kamilaris J, Hiegel AM, Carlisle SK, Smith PB, Scurlock AM, Jones SM, Burks AW (2013) Sublingual versus oral immunotherapy for peanut-allergic children: a retrospective comparison. J Allergy Clin Immunol 132(2):476–478 e2

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amy M. Scurlock.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Scurlock, A.M. Oral and Sublingual Immunotherapy for Treatment of IgE-Mediated Food Allergy. Clinic Rev Allerg Immunol 55, 139–152 (2018). https://doi.org/10.1007/s12016-018-8677-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12016-018-8677-0

Keywords

Navigation