International Journal of Pediatrics

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

News

Oral Immunotherapy in Children: Ige-Dependent Food Allergy to Milk or Wheat

Document Type : original article

Authors

1 Pediatric resident in Mashhad University of Medical Sciences

2 Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Oral Immunotherapy (OIT) is an effective strategy for improving food allergy tolerance. OIT has been introduced as a novel immune-modulating medication for food allergies. Other immunomodulatory approaches, such as sublingual (SLIT) or epicutaneous (EPIT) immunotherapy, may be less effective due to lower frequencies of systemic responses. Wheat and milk have lately been identified as a more prevalent cause of food-induced anaphylaxis than previously thought, particularly in young children worldwide. An immunoglobulin E (IgE)-dependent pathway may be responsible for wheat or milk allergy. The goal of our study was to offer a comprehensive evaluation of the effects of OIT in children with IGE-dependent food allergies to milk or wheat. Keywords related to OIT, food allergy, milk, wheat, and children were searched in MEDLINE, PubMed, Google Scholar, and ScienceDirect databases. Although oral immunotherapy for wheat allergy has recently been proposed, research studies have had encouraging results; despite, more research is still needed to determine the optimum strategy for promoting tolerance in wheat/milk-allergic children

Keywords

References
  1. Nwaru BI, Hickstein L, Panesar S, Muraro A, Werfel T, Cardona V, J Dubois AE, Halken S, Hoffmann-Sommergruber K, Poulsen LK, Roberts G, Ree RV, Vlieg-Boerstra BJ, Sheikh A, EAACI Food Allergy and Anaphylaxis Guidelines Group. The epidemiology of food allergy in Europe: a systematic review and meta‐analysis. Allergy. 2014; 69(1):62-75.
  2. Branum AM, Lukacs SL. Food allergy among children in the United States. Pediatrics. 2009; 124(6):1549-55.
  3. Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011; 128(1):e9-e17.
  4. Muraro A, Werfel T, Hoffmann‐Sommergruber K, Roberts G, Beyer K, Bindslev‐Jensen C, Cardona V, Dubois A, Dutoit G, Eigenmann P, Rivas MF, Halken S, Hickstein L, Høst A, Knol E, Lack G, Marchisotto MJ, Niggemann B, Nwaru BI, Papadopoulos NG, Poulsen LK, Santos AF, Skypala I, Schoepfer A, Ree RV, Venter C, Worm M, Vlieg-Boerstra B, Panesar S, Silva DD, Soares-Weiser K, Sheikh A, Ballmer-Weber BK, Nilsson C, Jong NWD, Akdis CA, EAACI Food Allergy and Anaphylaxis Guidelines Group. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014; 69(8):1008-25.
  5. Leblanc P, Moise L, Luza C, Chantaralawan K, Lezeau L, Yuan J, Field M, Richer D, Boyle C, Martin WD, Fishman JB, Berg EA, Baker D, Zeigler B, Mais DE, Taylor W, Coleman R, Warren HS, Gelfand JA, Groot ASD, Brauns T, Poznansky MC. VaxCelerate II: rapid development of a self-assembling vaccine for Lassa fever. Human Vaccines & Immunotherapeutics. 2014; 10(10):3022-38.
  6. Nowak-Węgrzyn A, Fiocchi A. Is oral immunotherapy the cure for food allergies? Current opinion in allergy and clinical immunology. 2010; 10(3):214-9.
  7. Pourpak Z, Farhoudi A, Arshi S, Movahedi M, Gharegozlou M, Yazdani F, Mesdaghi M. Common food allergens in Iranian children. Iranian Journal of Medical Sciences. 2015; 28(1):17-22.
  8. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, Hofmaier S, Aalberse RC, Agache I, Asero R, Ballmer-Weber B, Barber D, Beyer K, Biedermann T, Bilò MB, Blank S, Bohle B, Bosshard PP, Breiteneder H, Brough HA, Caraballo L, Caubet JC, Crameri R, Davies JM, Douladiris N, Ebisawa M, EIgenmann PA, Fernandez-Rivas M, Ferreira F, Gadermaier G, Glatz M, Hamilton RG, Hawranek T, Hellings P, Hoffmann-Sommergruber K, Jakob T, Jappe U, Jutel M, Kamath SD, Knol EF, Korosec P, Kuehn A, Lack G, Lopata AL, Mäkelä M, Morisset M, Niederberger V, Nowak-Węgrzyn AH, Papadopoulos NG, Pastorello EA, Pauli G, Platts-Mills T, Posa D, Poulsen LK, Raulf M, Sastre J, Scala E, Schmid JM, Schmid-Grendelmeier P, Hage MV, Ree RV, Vieths S, Weber R, Wickman M, Muraro A, Ollert M. EAACI molecular allergology user's guide. Pediatric Allergy and Immunology. 2016; 27:1-250.
  9. Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. The Lancet. 2013; 382(9905):1656-64.
  10. Linna O. Specific lgE antibodies to undigested cereals. Allergy. 1996; 51(11):849-50.
  11. Tatham A, Shewry P. Allergens to wheat and related cereals. Clinical & Experimental Allergy. 2008; 38(11):1712-26.
  12. Nilsson N, Sjölander S, Baar A, Berthold M, Pahr S, Vrtala S, Valenta R, Morita E, Hedlin G, Borres MP, Nilsson C. Wheat allergy in children evaluated with challenge and IgE antibodies to wheat components. Pediatric allergy and immunology. 2015; 26(2):119-25.
  13. Zhang Y, Jin T. Almond allergens: Update and perspective on identification and characterization. Journal of the Science of Food and Agriculture. 2020; 100(13):4657-63.
  14. Shibata R, Nishima S, Tanaka A, Borres MP, Morita E. Usefulness of specific IgE antibodies to ω-5 gliadin in the diagnosis and follow-up of Japanese children with wheat allergy. Annals of Allergy, Asthma & Immunology. 2011; 107(4):337-43.
  15. Ebisawa M, Shibata R, Sato S, Borres MP, Ito K. Clinical utility of IgE antibodies to ω-5 gliadin in the diagnosis of wheat allergy: a pediatric multicenter challenge study. International archives of allergy and immunology. 2012; 158(1):71-6.
  16. Sato S, Utsunomiya T, Imai T, Yanagida N, Asaumi T, Ogura K, Koike Y, Hayashi N, Okada Y, Shukuya A, Ebisawa M. Wheat oral immunotherapy for wheat-induced anaphylaxis. Journal of Allergy and Clinical Immunology. 2015; 136(4):1131-3. e7.
  17. Longo G, Barbi E, Berti I, Meneghetti R, Pittalis A, Ronfani L, Ventura A. Specific oral tolerance induction in children with very severe cow's milk–induced reactions. Journal of allergy and clinical immunology. 2008; 121(2):343-7.
  18. Meglio P, Bartone E, Plantamura M, Arabito E, Giampietro P. A protocol for oral desensitization in children with IgE‐mediated cow's milk allergy. Allergy. 2004; 59(9):980-7.
  19. Staden U, Blumchen K, Blankenstein N, Dannenberg N, Ulbricht H, Dobberstein K, Ziegert M, Niggemann B, Wahn U, Beyer K. Rush oral immunotherapy in children with persistent cow's milk allergy. Journal of Allergy and Clinical Immunology. 2008; 122(2):418-9.
  20. Skripak JM, Nash SD, Rowley H, Brereton NH, Oh S, Hamilton RG, Matsui EC, Burks AW, Wood RA. A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow's milk allergy. Journal of Allergy and Clinical Immunology. 2008; 122(6):1154-60.
  21. Calatayud CM, García AM, Aragonés AM, Caballer BDLH. Safety and efficacy profile and immunological changes associated with oral immunotherapy for IgE-mediated cow's milk allergy in children: systematic review and meta-analysis. J Investig Allergol Clin Immunol. 2014; 24(5):298-307.
  22. Imai T, Sugizaki C, Ebisawa M. A Report On 2011 Nationwide Survey Of Immediate Type Food Allergies In Japan (Supported By A Grant From" Consumer Affairs Agency, Government Of Japan"). Arerugi = [Allergy]. 2016; 65(7):942-6.
  23. Paassilta M, Salmivesi S, Mäki T, Helminen M, Korppi M. Children who were treated with oral immunotherapy for cows' milk allergy showed long‐term desensitization seven years later. Acta Paediatrica. 2016; 105(2):215-9.
  24. Dhami S, Nurmatov U, Pajno GB, Fernandez-Rivas M, Muraro A, Roberts G, Akdis C, Alvaro-Lozano M, Beyer K, Bindslev-Jensen C, Burks W, Toit GD, Ebisawa M, Eigenmann P, Knol E, Makela M, Nadeau KC, O'Mahony L, Papadopoulos N, Poulsen L, Sackesen C, Sampson H, Santos A, Ree RV, Timmermans F, Sheikh A. Allergen immunotherapy for IgE-mediated food allergy: protocol for a systematic review. Clinical and translational allergy. 2016; 6(1):1-5.
  25. Elizur A, Rajuan N, Goldberg MR, Leshno M, Cohen A, Katz Y. Natural course and risk factors for persistence of IgE-mediated cow's milk allergy. The Journal of pediatrics. 2012; 161(3):482-7. e1.
  26. Ben-Shoshan M, La Vieille S, Eisman H, Alizadehfar R, Mill C, Perkins E, Joseph L, Morris J, Clarke A. Anaphylaxis treated in a Canadian pediatric hospital: Incidence, clinical characteristics, triggers, and management. Journal of Allergy and Clinical Immunology. 2013; 132(3):739-41. e3.
  27. Byrne A, Malka‐Rais J, Burks A, Fleischer D. How do we know when peanut and tree nut allergy have resolved, and how do we keep it resolved? Clinical & Experimental Allergy. 2010; 40(9):1303-11.
  28. Dupont C, Kalach N, Soulaines P, Legoué-Morillon S, Piloquet H, Benhamou P-H. Cow's milk epicutaneous immunotherapy in children: a pilot trial of safety, acceptability, and impact on allergic reactivity. Journal of Allergy and Clinical Immunology. 2010; 125(5):1165-7.
  29. Fisher H, Du Toit G, Lack G. Specific oral tolerance induction in food allergic children: is oral desensitization more effective than allergen avoidance? a meta-analysis of published RCTs. Archives of disease in childhood. 2011; 96(3):259-64.
  30. Zapatero L, Alonso E, Fuentes V, Martinez M. Oral desensitization in children with cow’s milk allergy. J Investig Allergol Clin Immunol. 2008; 18(5):389-96.
  31. Patriarca C, Romano A, Venuti A, Schiavino D, Di Rienzo V, Nucera E, Pellegrino S. Oral specific hyposensitization in the management of patients allergic to food. Allergologia ET immunopathologia. 1984; 12(4):275-81.
  32. Ebrahimi M, Gharagozlou M, Mohebbi A, Hafezi N, Azizi G, Movahedi M. The efficacy of oral immunotherapy in patients with cow's milk allergy. Iranian Journal of Allergy, Asthma and Immunology. 2017:183-92.
  33. Inuo C, Tanaka K, Suzuki S, Nakajima Y, Yamawaki K, Tsuge I, Urisu A, Kondo Y. Oral immunotherapy using partially hydrolyzed formula for cow’s milk protein allergy: a randomized, controlled trial. International archives of allergy and immunology. 2018; 177(3):259-68.
  34. Echeverria L, Martin-Muñoz M, Martorell C, Belver M, Lebrero EA, Zapatero L, Fuentes V, Piqué M, Plaza A, Muñoz C, Martorell A, Blasco C, Villa B, Gómez C, Nevot S, García JM, Madero R. Clinical and immunological profile of children aged 5–9 years with persistent egg allergy before oral immunotherapy with egg. A multicenter, randomized controlled trial of the Spanish Society of Pediatric Allergy, Asthma and Clinical Immunology (SEICAP). Allergologia ET Immunopathologia. 2018; 46(5):415-20.
  35. Nucera E, Ricci AG, Rizzi A, Mezzacappa S, Di Rienzo A, Pecora V, Patriarca G, Buonomo A, Aruanno A, Schiavino D. Specific oral immunotherapy in food allergic patients: transient or persistent tolerance? Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2018; 35(4):392.
  36. Nachshon L, Goldberg MR, Katz Y, Levy MB, Elizur A. Long‐term outcome of peanut oral immunotherapy—Real‐life experience. Pediatric Allergy and Immunology. 2018; 29(5):519-26.
  37. Nagakura Ki, Yanagida N, Sato S, Nishino M, Asaumi T, Ogura K, Ebisawa M. Low‐dose oral immunotherapy for children with anaphylactic peanut allergy in Japan. Pediatric Allergy and Immunology. 2018; 29(5):512-8.
  38. Kulis MD, Patil SU, Wambre E, Vickery BP. Immune mechanisms of oral immunotherapy. Journal of Allergy and Clinical Immunology. 2018; 141(2):491-8.
  39. 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, Toit GD, Ebisawa M, Eigenmann P, Knol E, Makela M, Nadeau KC, O'Mahony L, Papadopoulos N, Poulsen LK, Sackesen C, Sampson H, Santos AF, Ree RV, Timmermans F, Sheikh A. Allergen immunotherapy for IgE‐mediated food allergy: a systematic review and meta‐analysis. Allergy. 2017; 72(8):1133-47.
  40. Ogata M, Kido J, Nakamura K. Oral Immunotherapy for Children with Cow’s Milk Allergy. Pathogens. 2021; 10(10):1328.
  41. Pasha I, Saeed F, Sultan MT, Batool R, Aziz M, Ahmed W. Wheat allergy and intolerance; Recent updates and perspectives. Critical reviews in food science and nutrition. 2016; 56(1):13-24.
  42. Ricci G, Andreozzi L, Cipriani F, Giannetti A, Gallucci M, Caffarelli C. Wheat allergy in children: a comprehensive update. Medicina. 2019; 55(7):400.
  43. Keet C, Matsui E, Mudd K, Paterakis M, Wood R. The natural history of wheat allergy. Journal of Allergy and Clinical Immunology. 2008; 121(2):S236.
  44. Siripipat Rattanamongkol N, Vichyanond P, Jirapongsananuruk O, Veskitkul J, Visitsunthorn N, Pacharn P. Age of resolution from IgE-mediated wheat allergy. Asian Pacific journal of allergy and immunology. 2017; 35(2):113-7.
  45. Koike Y, Yanagida N, Sato S, Asaumi T, Ogura K, Ohtani K, Imai T, Ebisawa M. Predictors of persistent wheat allergy in children: a retrospective cohort study. International Archives of Allergy and Immunology. 2018; 176(3-4):249-54.
  46. Keet CA, Matsui EC, Dhillon G, Lenehan P, Paterakis M, Wood RA. The natural history of wheat allergy. Annals of Allergy, Asthma & Immunology. 2009; 102(5):410-5.
  47. Czaja-Bulsa G, Bulsa M. The natural history of IgE mediated wheat allergy in children with dominant gastrointestinal symptoms. Allergy, Asthma & Clinical Immunology. 2014; 10(1):1-7.
  48. Kotaniemi‐Syrjänen A, Palosuo K, Jartti T, Kuitunen M, Pelkonen AS, Mäkelä MJ. The prognosis of wheat hypersensitivity in children. Pediatric Allergy and Immunology. 2010; 21(2p2):e421-e8.
  49. Baar A, Pahr S, Constantin C, Giavi S, Manoussaki A, Papadopoulos NG, Ebner C, Mari A, Vrtala S, Valenta R. Specific IgE reactivity to Tri a 36 in children with wheat food allergy. Journal of Allergy and Clinical Immunology. 2014; 133(2):585-7.
  50. Matricardi P, Bockelbrink A, Beyer K, Keil T, Niggemann B, Grüber C, Wahn U, Lau S. Primary versus secondary immunoglobulin E sensitization to soy and wheat in the Multi‐Centre Allergy Study cohort. Clinical & Experimental Allergy. 2008; 38(3):493-500.
International Journal of Pediatrics
Volume 10, Issue 8
August 2022
Pages 16505-16514
Files
Share
How to cite
Statistics