Oral immunotherapy for food allergy, ready for prime time? Heated egg and milk

Cow's milk and hen's egg allergies are two of the most common food allergies that affect children, with an estimated prevalence of 2-3 % each. Persistence of food allergy into late teen years and adulthood is being increasingly recognized, possibly due to strict avoidance practices. Heating has been known to alter food allergenicity, and the majority of milk- and egg-allergic patients tolerate heated forms of those foods. Heated milk and heated egg have been increasingly studied as oral immunotherapy (OIT) for treatment of milk and egg allergy. While heated milk and heated egg have been shown to be safe in selected milk- and egg-allergic cohorts, larger studies are needed to predict which patients are optimal candidates for this strategy and to further clarify whether ingestion of heated milk or heated egg truly accelerates the onset of clinical tolerance to unheated forms of these foods.