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Specific oral tolerance induction in children with very severe cow's milk-induced reactions

Giorgio Longo1, Egidio Barbi, Irene Berti

  • 1Pediatric Department, D.S.R.S., I.R.C.C.S. "Burlo Garofolo," University of Trieste, Trieste, Italy.

The Journal of Allergy and Clinical Immunology
|December 26, 2007
PubMed

Insights

Specific oral tolerance induction (SOTI) helped many children with severe cow's milk protein (CMP) allergies achieve tolerance or consume limited amounts of milk, showing SOTI's effectiveness.

Area of Science:

  • Allergy and Immunology
  • Pediatric Gastroenterology

Background:

  • Cow's milk protein (CMP) allergy can cause severe reactions in children, even with trace amounts.
  • Current management relies on strict avoidance and epinephrine auto-injectors.

Purpose of the Study:

  • To assess the safety and efficacy of specific oral tolerance induction (SOTI) for children with severe CMP allergy.
  • To evaluate SOTI's impact on children experiencing systemic reactions to CMP.

Main Methods:

  • A double-blind, placebo-controlled study involved 97 children aged 5+ with severe CMP allergy.
  • Sixty children with positive challenges began SOTI (Group A) or a milk-free diet (Group B) for one year.

Main Results:

  • After one year, 36% of Group A achieved full tolerance, and 54% could consume limited milk amounts.
  • No children in Group B achieved tolerance; all had positive challenges post-study.
  • 10% in Group A discontinued SOTI due to adverse reactions.

Conclusions:

  • Specific oral tolerance induction (SOTI) demonstrated significant efficacy in a substantial portion of children with severe CMP allergy.
  • SOTI offers a potential therapeutic strategy beyond avoidance for managing severe food allergies in children.
Abstract

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