Specific oral tolerance induction with raw hen’s egg in children with very severe egg allergy: A randomized controlled trial
Article first published online: 9 SEP 2012
© 2012 John Wiley & Sons A/S
Pediatric Allergy and Immunology
Volume 24, Issue 1, pages 66–74, February 2013
How to Cite
Dello Iacono, I., Tripodi, S., Calvani, M., Panetta, V., Verga, M. C. and Miceli Sopo, S. (2013), Specific oral tolerance induction with raw hen’s egg in children with very severe egg allergy: A randomized controlled trial. Pediatric Allergy and Immunology, 24: 66–74. doi: 10.1111/j.1399-3038.2012.01349.x
- Issue published online: 20 JAN 2013
- Article first published online: 9 SEP 2012
- Accepted for publication 26 June 2012
- food allergy;
- hen’s egg;
- skin prick test;
- end-point skin prick test;
- double-blind placebo-controlled food challenge;
- specific oral tolerance induction
To cite this article: Dello Iacono I, Tripodi S, Calvani M, Panetta V, Verga MC, Miceli Sopo S. Specific oral tolerance induction with raw hen’s egg in children with very severe egg allergy: A randomized controlled trial. Pediatr Allergy Immunol 2012: 00.
Background: Treatment of severe egg allergy is avoidance of hen’s egg (HE) and carrying self-injectable epinephrine. Specific oral tolerance induction (SOTI) seems a promising alternative treatment. However, some aspects of SOTI are still considered experimental.
Methods: We evaluated the efficacy and safety of an original 6-month SOTI protocol in children with very severe HE allergy using raw HE emulsion. Twenty children (age range: 5–11 yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6 months later. Control children were kept on an egg-free diet for 6 months and then underwent a second challenge.
Results: After 6 months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10 ml, but <40 ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5 ml (no tolerance). After 6 months, nine control children tested positive to the second challenge at a dose ≤0.9 ml of raw HE emulsion, and one reacted to 1.8 ml (SOTI vs. control group p < 0.0001). All children in the SOTI group had side effects, but no child had a grade 5 reaction according to the Sampson grading.
Conclusion: Six months of SOTI with raw HE emulsion resulted in partial tolerance, with regular intake, in a significant percentage of children with severe egg allergy.