Related Experiment Video
Updated: May 30, 2026
22:06
Induction and Monitoring of Adoptive Delayed-Type Hypersensitivity in Rats
Published on: October 1, 2007
Adverse effects during specific oral tolerance induction: in home phase
1Emergency Department, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, University of Trieste, Italy.
Allergologia Et Immunopathologia
|August 2, 2011
Summary
The home phase of specific oral tolerance induction (SOTI) for cow's milk allergy involves frequent adverse reactions, but these are manageable. Nebulized epinephrine is key for respiratory issues, with high IgE and low doses increasing risk.
Area of Science:
- Immunology
- Allergy and Immunology
- Pediatric Allergy
Background:
- Specific oral tolerance induction (SOTI) shows promise for severe food allergies.
- Limited data exists on the home-phase management of SOTI, including adverse reactions and optimal protocols.
Purpose of the Study:
- To determine the incidence, severity, and risk factors of adverse reactions during the home-phase of SOTI for severe cow's milk (CM) allergy.
- To assess the safety and effectiveness of an original SOTI protocol in children after the initial hospital phase.
Main Methods:
- Prospective data collection on home-phase adverse events, treatment success/failure, and parental reporting.
- Adverse reactions managed per international guidelines, with modifications including nebulized epinephrine for respiratory symptoms and oral medications for gastric issues.
Main Results:
- Out of 132 contacted patients, 1 adverse reaction occurred per 100 doses.
- Nebulized epinephrine was the primary treatment for 221 reactions; IM epinephrine was used in 6.
- Higher risk of reactions and nebulized epinephrine use was associated with high specific IgE levels (>100 kU(A)/L) and lower CM doses (<5 ml).
Conclusions:
- The home-phase of SOTI in children with CM allergy resulted in numerous adverse reactions.
- Most reactions were managed effectively with acceptable side effects.
- Nebulized epinephrine was crucial for managing respiratory adverse events during home-phase SOTI.
Related Concept Videos
01:12Local Anesthetics: Adverse Effects
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
01:16Drug toxicity: Idiosyncratic Reactions
Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
01:24Drug Toxicity: Dose-Dependent Reactions
Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
01:20Desensitization and Tachyphylaxis
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
Several...
Several...
01:29Hypersensitivity Reactions: Delayed Hypersensitivity Reactions
Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...
01:30Drug Toxicity: Allergic Reactions
Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...