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Erschienen in: Drugs 15/2012

01.11.2012 | Review Article

Sublingual vs Oral Immunotherapy for Food Allergy

Identifying the Right Approach

verfasst von: Satya D. Narisety, Dr Corinne A. Keet, M.D, M.S.

Erschienen in: Drugs | Ausgabe 15/2012

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Abstract

The incidence of food allergy in developed countries has increased in recent years, escalating the need to find a suitable form of treatment as an alternative to current management, which includes strict avoidance and ready availability of injectable epinephrine (adrenaline). Allergen immunotherapy is currently being studied for use in the treatment of IgE-mediated food allergy to the most common foods, including peanut, tree nut, milk and egg. Two modalities, oral immunotherapy (OIT) and sublingual immunotherapy (SLIT), have shown great promise. Both OIT and SLIT have been able to desensitize subjects to varying degrees, but the two treatment methods differ in doses that can be achieved, duration of treatment, safety profile and ease of use outside the research setting, among other aspects. More research is needed to conclude which mode of treatment is more effective in inducing long-term tolerance with the least amount of serious adverse reactions. However, OIT and SLIT show great promise, and a widespread treatment for food allergy may be within reach.
Literatur
1.
Zurück zum Zitat Boyce J, Assa’ad AH, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Allergy Clin Immunol 2010; 126 (6 Suppl.): S1–58PubMedCrossRef Boyce J, Assa’ad AH, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Allergy Clin Immunol 2010; 126 (6 Suppl.): S1–58PubMedCrossRef
2.
Zurück zum Zitat Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief 2008 Oct; (10): 1–8PubMed Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief 2008 Oct; (10): 1–8PubMed
3.
Zurück zum Zitat Sicherer SH, Munoz-Furlong A, Godbold JH, et al. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol 2010; 125 (6): 1322–6PubMedCrossRef Sicherer SH, Munoz-Furlong A, Godbold JH, et al. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol 2010; 125 (6): 1322–6PubMedCrossRef
4.
Zurück zum Zitat Decker WW, Campbell RL, Manivannan V, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol 2008; 122 (6): 1161–5PubMedCrossRef Decker WW, Campbell RL, Manivannan V, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol 2008; 122 (6): 1161–5PubMedCrossRef
5.
Zurück zum Zitat Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol 2001; 107(1): 191–3PubMedCrossRef Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol 2001; 107(1): 191–3PubMedCrossRef
6.
Zurück zum Zitat Bock SA, Munoz-Furlong A, Sampson HA. Further fatalities caused by anaphylactic reactions to food, 2001–2006. J Allergy Clin Immunol 2007; 119 (4): 1016–8PubMedCrossRef Bock SA, Munoz-Furlong A, Sampson HA. Further fatalities caused by anaphylactic reactions to food, 2001–2006. J Allergy Clin Immunol 2007; 119 (4): 1016–8PubMedCrossRef
7.
8.
Zurück zum Zitat Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol 2011; 127: 18–27PubMedCrossRef Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol 2011; 127: 18–27PubMedCrossRef
9.
Zurück zum Zitat Viswanathan RK, Busse WW. Allergen immunotherapy in allergic respiratory diseases: from mechanisms to meta-analysis. Chest 2012; 141 (5): 1303–14PubMedCrossRef Viswanathan RK, Busse WW. Allergen immunotherapy in allergic respiratory diseases: from mechanisms to meta-analysis. Chest 2012; 141 (5): 1303–14PubMedCrossRef
10.
Zurück zum Zitat Oppenheimer JJ, Nelson HS, Bock SA, et al. Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol 1992; 90 (2): 256–62PubMedCrossRef Oppenheimer JJ, Nelson HS, Bock SA, et al. Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol 1992; 90 (2): 256–62PubMedCrossRef
11.
Zurück zum Zitat Nelson HS, Lahr J, Rule R, et al. Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. J Allergy Clin Immunol 1997; 99 (6 Pt 1): 744–51PubMedCrossRef Nelson HS, Lahr J, Rule R, et al. Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. J Allergy Clin Immunol 1997; 99 (6 Pt 1): 744–51PubMedCrossRef
12.
Zurück zum Zitat Allam JP, Stojanovski G, Friedrichs N, et al. Distribution of Langerhans cells and mast cells within the human oral mucosa: new application sites of allergens in sublingual immunotherapy? Allergy 2008; 63: 720–7PubMedCrossRef Allam JP, Stojanovski G, Friedrichs N, et al. Distribution of Langerhans cells and mast cells within the human oral mucosa: new application sites of allergens in sublingual immunotherapy? Allergy 2008; 63: 720–7PubMedCrossRef
13.
Zurück zum Zitat Chafen JJ, Newberry SJ, Riedl MA, et al. Diagnosing and managing common food allergies: a systematic review. JAMA 2010; 303 (18): 1848–56PubMedCrossRef Chafen JJ, Newberry SJ, Riedl MA, et al. Diagnosing and managing common food allergies: a systematic review. JAMA 2010; 303 (18): 1848–56PubMedCrossRef
14.
Zurück zum Zitat Brozek JL, Terracciano L, Hsu J, et al. Oral immunotherapy for IgE-mediated cow’s milk allergy: a systematic review and meta-analysis. Clin Exp Allergy 2012; 42 (3): 363–74PubMedCrossRef Brozek JL, Terracciano L, Hsu J, et al. Oral immunotherapy for IgE-mediated cow’s milk allergy: a systematic review and meta-analysis. Clin Exp Allergy 2012; 42 (3): 363–74PubMedCrossRef
15.
Zurück zum Zitat Skripak JM, Matsui EC, Mudd K, et al. The natural history of IgE-mediated cow’s milk allergy. J Allergy Clin Immunol 2007; 120 (5): 1172–7PubMedCrossRef Skripak JM, Matsui EC, Mudd K, et al. The natural history of IgE-mediated cow’s milk allergy. J Allergy Clin Immunol 2007; 120 (5): 1172–7PubMedCrossRef
16.
Zurück zum Zitat Savage JH, Matsui EC, Skripak JM, et al. The natural history of egg allergy. J Allergy Clin Immunol 2007; 120 (6): 1413–7PubMedCrossRef Savage JH, Matsui EC, Skripak JM, et al. The natural history of egg allergy. J Allergy Clin Immunol 2007; 120 (6): 1413–7PubMedCrossRef
17.
Zurück zum Zitat Skolnick HS, Conover-Walker MK, Koerner CB, et al. The natural history of peanut allergy. J Allergy Clin Immunol 2001; 107(2): 367–74PubMedCrossRef Skolnick HS, Conover-Walker MK, Koerner CB, et al. The natural history of peanut allergy. J Allergy Clin Immunol 2001; 107(2): 367–74PubMedCrossRef
18.
Zurück zum Zitat Patriarca G, Nucera E, Roncallo C, et al. Oral desensitizing treatment in food allergy: clinical and immunological results. Aliment Pharmacol Ther 2003; 17 (3): 459–65PubMedCrossRef Patriarca G, Nucera E, Roncallo C, et al. Oral desensitizing treatment in food allergy: clinical and immunological results. Aliment Pharmacol Ther 2003; 17 (3): 459–65PubMedCrossRef
19.
Zurück zum Zitat Meglio P, Bartone E, Plantamura M, et al. A protocol for oral desensitization in children with IgE-mediated cow’s milk allergy. Allergy 2004; 59 (9): 980–7PubMedCrossRef Meglio P, Bartone E, Plantamura M, et al. A protocol for oral desensitization in children with IgE-mediated cow’s milk allergy. Allergy 2004; 59 (9): 980–7PubMedCrossRef
20.
Zurück zum Zitat Staden U, Rolinck-Werninghaus C, Brewe F, et al. Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction. Allergy 2007; 62 (11): 1261–9PubMedCrossRef Staden U, Rolinck-Werninghaus C, Brewe F, et al. Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction. Allergy 2007; 62 (11): 1261–9PubMedCrossRef
21.
Zurück zum Zitat Buchanan AD, Green TD, Jones SM, et al. Egg oral immunotherapy in nonanaphylactic children with egg allergy. J Allergy Clin Immunol 2007; 119 (1): 199–205PubMedCrossRef Buchanan AD, Green TD, Jones SM, et al. Egg oral immunotherapy in nonanaphylactic children with egg allergy. J Allergy Clin Immunol 2007; 119 (1): 199–205PubMedCrossRef
22.
Zurück zum Zitat Longo G, Barbi E, Berti I, et al. Specific oral tolerance induction in children with very severe cow’s milk-induced reactions. J Allergy Clin Immunol 2008; 121 (2): 343–7PubMedCrossRef Longo G, Barbi E, Berti I, et al. Specific oral tolerance induction in children with very severe cow’s milk-induced reactions. J Allergy Clin Immunol 2008; 121 (2): 343–7PubMedCrossRef
23.
Zurück zum Zitat Skripak JM, Nash SD, Rowley H, et al. A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow’s milk allergy. J Allergy Clin Immunol 2008; 122 (6): 1154–60PubMedCrossRef Skripak JM, Nash SD, Rowley H, et al. A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow’s milk allergy. J Allergy Clin Immunol 2008; 122 (6): 1154–60PubMedCrossRef
24.
Zurück zum Zitat Clark AT, Islam S, King Y, et al. Successful oral tolerance induction in severe peanut allergy. Allergy 2009; 64 (8): 1218–20PubMedCrossRef Clark AT, Islam S, King Y, et al. Successful oral tolerance induction in severe peanut allergy. Allergy 2009; 64 (8): 1218–20PubMedCrossRef
25.
Zurück zum Zitat Jones SM, Pons L, Roberts JL, et al. Clinical efficacy and immune regulation with peanut oral immunotherapy. J Allergy Clin Immunol 2009; 124 (2): 292–300PubMedCrossRef Jones SM, Pons L, Roberts JL, et al. Clinical efficacy and immune regulation with peanut oral immunotherapy. J Allergy Clin Immunol 2009; 124 (2): 292–300PubMedCrossRef
26.
Zurück zum Zitat Blumchen K, Ulbricht H, Staden U, et al. Oral peanut immunotherapy in children with peanut anaphylaxis. J Allergy Clin Immunol 2010; 126 (1): 83–91PubMedCrossRef Blumchen K, Ulbricht H, Staden U, et al. Oral peanut immunotherapy in children with peanut anaphylaxis. J Allergy Clin Immunol 2010; 126 (1): 83–91PubMedCrossRef
27.
Zurück zum Zitat Pajno GB, Caminiti L, Ruggeri P, et al. Oral immunotherapy for cow’s milk allergy with a weekly up-dosing regimen: a randomized single-blind controlled study. Ann Allergy Asthma Immunol 2010; 105: 376–81PubMedCrossRef Pajno GB, Caminiti L, Ruggeri P, et al. Oral immunotherapy for cow’s milk allergy with a weekly up-dosing regimen: a randomized single-blind controlled study. Ann Allergy Asthma Immunol 2010; 105: 376–81PubMedCrossRef
28.
Zurück zum Zitat Martorell A, De la Hoz B, Ibanez MD, et al. Oral desensitization as a useful treatment in 2-year-old children with cow’s milk allergy. Clin Exp Allergy 2011; 41 (9): 1297–304PubMedCrossRef Martorell A, De la Hoz B, Ibanez MD, et al. Oral desensitization as a useful treatment in 2-year-old children with cow’s milk allergy. Clin Exp Allergy 2011; 41 (9): 1297–304PubMedCrossRef
29.
Zurück zum Zitat Garcia Rodriguez R, Urra JM, Feo-Brito F, et al. Oral rush desensitization to egg: efficacy and safety. Clin Exp Allergy 2011; (41): 1289–96PubMedCrossRef Garcia Rodriguez R, Urra JM, Feo-Brito F, et al. Oral rush desensitization to egg: efficacy and safety. Clin Exp Allergy 2011; (41): 1289–96PubMedCrossRef
30.
Zurück zum Zitat Anagnostau K, Clark A, King Y, et al. Efficacy and safety of high-dose peanut oral immunotherapy with factors predicting outcome. Clin Exp Allergy 2011; 41: 1273–81CrossRef Anagnostau K, Clark A, King Y, et al. Efficacy and safety of high-dose peanut oral immunotherapy with factors predicting outcome. Clin Exp Allergy 2011; 41: 1273–81CrossRef
31.
Zurück zum Zitat Burks AW, Jones SM, Wood RA, et al. Oral immunotherapy for treatment of egg allergy in children. N Engl J Med 2012; 367: 233–43PubMedCrossRef Burks AW, Jones SM, Wood RA, et al. Oral immunotherapy for treatment of egg allergy in children. N Engl J Med 2012; 367: 233–43PubMedCrossRef
32.
Zurück zum Zitat Enrique E, Pineda F, Malek T, et al. Sublingual immunotherapy for hazelnut food allergy: a randomized, double-blind, placebo-controlled study with a standardized hazelnut extract. J Allergy Clin Immunol 2005; 116 (5): 1073–9PubMedCrossRef Enrique E, Pineda F, Malek T, et al. Sublingual immunotherapy for hazelnut food allergy: a randomized, double-blind, placebo-controlled study with a standardized hazelnut extract. J Allergy Clin Immunol 2005; 116 (5): 1073–9PubMedCrossRef
33.
Zurück zum Zitat De Boissieu D, Dupont C. Sublingual immunotherapy for cow’s milk protein allergy: a preliminary report. Allergy 2006; 61 (10): 1238–9PubMedCrossRef De Boissieu D, Dupont C. Sublingual immunotherapy for cow’s milk protein allergy: a preliminary report. Allergy 2006; 61 (10): 1238–9PubMedCrossRef
34.
Zurück zum Zitat Fernandez-Rivas M, Garrido FS, Nadal JA, et al. Randomized double-blind, placebo-controlled trial of sublingual immunotherapy with a Pru p 3 quantified peach extract. Allergy 2009; 64 (6): 876–83PubMedCrossRef Fernandez-Rivas M, Garrido FS, Nadal JA, et al. Randomized double-blind, placebo-controlled trial of sublingual immunotherapy with a Pru p 3 quantified peach extract. Allergy 2009; 64 (6): 876–83PubMedCrossRef
35.
Zurück zum Zitat Kim EH, Bird JA, Kulis M, et al. Sublingual immunotherapy for peanut allergy: clinical and immunological evidence of desensitization. J Allergy Clin Immunol 2011; 127 (3): 640–6.e1PubMedCrossRef Kim EH, Bird JA, Kulis M, et al. Sublingual immunotherapy for peanut allergy: clinical and immunological evidence of desensitization. J Allergy Clin Immunol 2011; 127 (3): 640–6.e1PubMedCrossRef
36.
Zurück zum Zitat Keet CA, Frischmeyer-Guerrerio PA, Thyagarajan A, et al. The safety and efficacy of sublingual and oral immunotherapy for milk allergy. J Allergy Clin Immunol 2012 Feb; 129 (2): 448–55, 455.e1–5PubMedCrossRef Keet CA, Frischmeyer-Guerrerio PA, Thyagarajan A, et al. The safety and efficacy of sublingual and oral immunotherapy for milk allergy. J Allergy Clin Immunol 2012 Feb; 129 (2): 448–55, 455.e1–5PubMedCrossRef
37.
Zurück zum Zitat Narisety SD, Skripak JM, Steele P, et al. Open-label maintenance after milk oral immunotherapy for IgE-mediated cow’s milk allergy. J Allergy Clin Immunol 2009; 124 (3): 610–2PubMedCrossRef Narisety SD, Skripak JM, Steele P, et al. Open-label maintenance after milk oral immunotherapy for IgE-mediated cow’s milk allergy. J Allergy Clin Immunol 2009; 124 (3): 610–2PubMedCrossRef
38.
Zurück zum Zitat Hofmann AM, Scurlock AM, Jones SM, et al. Safety of a peanut oral immunotherapy protocol in children with peanut allergy. J Allergy Clin Immunol 2009; 124 (2): 286–91. 291 e281–286PubMedCrossRef Hofmann AM, Scurlock AM, Jones SM, et al. Safety of a peanut oral immunotherapy protocol in children with peanut allergy. J Allergy Clin Immunol 2009; 124 (2): 286–91. 291 e281–286PubMedCrossRef
39.
Zurück zum Zitat Varshney P, Steele PH, Vickery BP, et al. Adverse reactions during peanut oral immunotherapy home dosing. J Allergy Clin Immunol 2009; 124 (6): 1351–2PubMedCrossRef Varshney P, Steele PH, Vickery BP, et al. Adverse reactions during peanut oral immunotherapy home dosing. J Allergy Clin Immunol 2009; 124 (6): 1351–2PubMedCrossRef
40.
Zurück zum Zitat Mempel M, Rakoski J, Ring J, et al. Severe anaphylaxis to kiwi fruit: immunologic changes related to successful sublingual allergen immunotherapy. J Allergy Clin Immunol 2003; 111 (6): 1406–140PubMedCrossRef Mempel M, Rakoski J, Ring J, et al. Severe anaphylaxis to kiwi fruit: immunologic changes related to successful sublingual allergen immunotherapy. J Allergy Clin Immunol 2003; 111 (6): 1406–140PubMedCrossRef
41.
Zurück zum Zitat Kerzl R, Simonowa A, Ring J, et al. Life-threatening anaphylaxis to kiwi fruit: protective sublingual allergen immunotherapy effect persists even after discontinuation. J Allergy Clin Immunol 2007; 119 (2): 507–8PubMedCrossRef Kerzl R, Simonowa A, Ring J, et al. Life-threatening anaphylaxis to kiwi fruit: protective sublingual allergen immunotherapy effect persists even after discontinuation. J Allergy Clin Immunol 2007; 119 (2): 507–8PubMedCrossRef
42.
Zurück zum Zitat Enrique E, Malek T, Pineda F, et al. Sublingual immunotherapy for hazelnut food allergy: a follow-up study. Ann Allergy Asthma Immunol 2008; 100 (3): 283–4PubMedCrossRef Enrique E, Malek T, Pineda F, et al. Sublingual immunotherapy for hazelnut food allergy: a follow-up study. Ann Allergy Asthma Immunol 2008; 100 (3): 283–4PubMedCrossRef
43.
Zurück zum Zitat Narisety SD, Keet CA, Guerrerio P, et al. A randomized, double-blind, placebo-controlled pilot study of sublingual versus oral immunotherapy for the treatment of peanut allergy [abstract]. J Allergy Clin Immunol 2012 Feb; 129 (2 Suppl.): AB27CrossRef Narisety SD, Keet CA, Guerrerio P, et al. A randomized, double-blind, placebo-controlled pilot study of sublingual versus oral immunotherapy for the treatment of peanut allergy [abstract]. J Allergy Clin Immunol 2012 Feb; 129 (2 Suppl.): AB27CrossRef
Metadaten
Titel
Sublingual vs Oral Immunotherapy for Food Allergy
Identifying the Right Approach
verfasst von
Satya D. Narisety
Dr Corinne A. Keet, M.D, M.S.
Publikationsdatum
01.11.2012
Verlag
Springer International Publishing
Erschienen in
Drugs / Ausgabe 15/2012
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI
https://doi.org/10.2165/11640800-000000000-00000

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