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Efficacy of oral immunotherapy protocol for specific oral tolerance induction in children with cow's milk allergy.

Abstract

BACKGROUND
In the last two decades milkoralimmunotherapy has gained interest as an effective treatment option for milk-allergic patients.
OBJECTIVES
To report on the efficacy of a milk oral immunotherapy.
METHODS
Children with immunoglobulin E-mediated cow's milk allergy were included in the protocol. The treatment consisted of an induction phase in which milk doses were increased weekly in the hospital, while the tolerated dose was continued daily at home. The goal was to achieve a minimum milk intake of 200 ml a day. During the maintenance phase, patients ingested at least 200 ml of milk in a single dose every day.
RESULTS
The protocol was applied to 105 milk-allergic children diagnosed by specific IgE to milk and controlled oral food challenge. The mean duration of the induction phase was 19 weeks. Of the 105 subjects, 86 (81.9%) successfully complied with the protocol and 19 (19.1%) failed. Causes of failure were moderate/severe reactions in 12 patients (12.44%) and personal reasons in 7 (6.66%). A total of 182 adverse reactions occurred during the induction phase, most of them mild. Baseline specific IgE to milk and casein was significantly lower (P < 0.05) in the successfully treated group compared to the group in which the treatment failed.
CONCLUSIONS
Milk oral immunotherapy is a safe and effective treatment for milk-allergic children, although adverse reactions may occur. Baseline milk and casein-specific IgE may be useful to predict a good response to milk oral immunotherapy.

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  • Publisher Full Text

    • Authors

    Sánchez-García S, Rodríguez del Río P, Escudero C, García-Fernández C, Ramirez A, Ibáñez MD

    Institution

    Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain. ssanchez@salud.madrid.org

    Source

    The Israel Medical Association journal : IMAJ 14:1 2012 Jan pg 43-7

    MeSH

    Administration, Oral
    Adolescent
    Allergens
    Child
    Child, Preschool
    Desensitization, Immunologic
    Female
    Humans
    Male
    Milk Hypersensitivity
    Milk Proteins
    Prospective Studies
    Skin Tests

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22624442