Oral desensitization for immunoglobulin E-mediated milk and egg allergies

Food allergy is an increasingly prevalent disease in western countries, but an effective form of therapy has not yet been found. A specific active treatment for immunoglobulin E (IgE)-mediated food allergy is currently under study in human clinical trials. Allergen-specific approaches include oral, sublingual and epicutaneous immunotherapy. Currently, reports on oral immunotherapy (OIT) have been more extensive than reports on other routes such as sublingual immunotherapy (SLIT) and epicutaneous patch. The aim of OIT using foods, especially milk and egg--the cause of most common allergies in infants and young children in Europe--is the achievement of desensitization or tolerance by patients suffering from food allergy. Treatment protocols have been initiated in highly supervised research settings with the goal of finding an active treatment against IgE-mediated food allergy. The preliminary data on OIT are encouraging, and among the plethora of novel approaches the strategies most likely to advance into clinical practice include both OIT and SLIT. It is still unclear whether oral desensitization is only the first step toward permanent desensitization or whether it induces only a transient tolerance. Longer duration of desensitization may result in permanent tolerance. The occurrence of adverse events or reactions during OIT is quite frequent and has been reported in all published studies. Therefore, before this treatment can be used in clinical practice additional studies are needed. Currently, immunotherapy for cow's milk or egg allergies is a novel approach that expands the possibility of an active treatment to improve the quality of life of patients and their families.