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Egg desensitization is achieved effectively and safely through a low maintenance dose protocol.

Diana Toscano-Rivero¹, Nofar Kimchi², Wei Zhao¹

¹Division of Experimental Medicine, Department of Medicine, McGill University and the Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada.

The Journal of Allergy and Clinical Immunology. Global

|September 22, 2025

Summary

Low-dose egg oral immunotherapy (E-OIT) at 300 mg is safe and effective for desensitizing children with egg allergy. This approach significantly increases the tolerated egg dose with minimal adverse reactions, offering a promising treatment option.

Keywords:

DBPCFC Food allergy allergic reactions egg allergy low dose oral food challenge oral immunotherapy skin prick test

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Area of Science:

Allergy and Immunology
Pediatric Medicine
Food Science

Background:

Egg allergy is a prevalent IgE-mediated food allergy in children.
Oral immunotherapy (OIT) involves gradual allergen exposure to reduce allergic reactions.
High-dose OIT carries risks; evidence for low-dose egg OIT (E-OIT) is limited.

Purpose of the Study:

To evaluate the safety and effectiveness of a low dose (300 mg) of E-OIT for inducing desensitization in children with egg allergy.

Main Methods:

Twenty children were randomized into immediate-treatment or observation groups.
Assessed cumulative tolerated dose (CTD), specific IgE (sIgE), specific IgG4 (sIgG4), and skin prick test responses.
Monitored adverse events throughout the study.

Main Results:

E-OIT significantly increased CTD from a median of 14.1 mg to 6000 mg.
Adverse reactions were infrequent (15.6% of doses) and mostly mild.
Skin prick test wheal diameters decreased, while sIgG4 levels increased and sIgE levels declined.

Conclusions:

A low maintenance dose of 300 mg E-OIT is safe and effective for treating egg allergy.
This approach induces significant clinical and immunological changes.
Low-dose E-OIT offers a favorable risk-benefit profile for pediatric egg allergy management.