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Clinical efficacy and immunological changes subjacent to egg oral immunotherapy

AuthorsPerezábad, Laura; Reche, Marta; Valbuena, Teresa; López-Fandiño, Rosina ; Molina, Elena ; López-Expósito, Iván
Issue Date2015
CitationAnnals of Allergy, Asthma and Immunology 114(6): 504-509 (2015)
Abstract[Background]: Evidence of the efficacy of food oral immunotherapy (OIT) is not robust enough to change clinical practice from current standard management. Furthermore, the immunologic changes underlying food desensitization are unknown. [Objective]: To establish the immunologic basal status and differences between an egg-allergic group of children and a population of nonallergic children and to investigate the safety and efficacy of a specific egg OIT protocol to induce clinical desensitization and the associated immune responses. [Methods]: Children with or without egg allergy were recruited. Allergic subjects underwent an OIT protocol based on weekly doses of egg protein and a maintenance phase. Immune profile and changes in all subjects were investigated by measuring T-helper cells types 1 and 2 (TH1 and TH2) and T-regulatory cytokines and transcription factors and egg-specific IgE and IgG4 levels. [Results]: At baseline, a significantly lower production of ovalbumin-specific interleukin (IL)-10 and tumor necrosis factor-α and a trend toward higher IL-5 and IL-13 were found in allergic children. The egg OIT protocol enabled 60% of them to ingest 32 mL of egg white. Significant increases in egg-specific IgG4 levels and IL-10 production, with a trend toward lower IL-5 and IL-13 and higher tumor necrosis factor-α and interferon-γ levels, and significant decreases in egg-specific IgE concentration were observed. Conclusion Egg-allergic individuals display a bias toward T<inf>H</inf>2 type cytokine production and decreased TH1 and IL-10 responses compared with nonallergic individuals. The OIT protocol was safe and effective in inducing egg desensitization, leading to a shift in the immune profile of allergic individuals toward a nonallergic phenotype.
Identifiersdoi: 10.1016/j.anai.2015.04.006
e-issn: 1534-4436
issn: 1081-1206
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