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. 2018 Jun 15;11(1):12.
doi: 10.1186/s40413-018-0189-0. eCollection 2018.

Debates in Allergy Medicine: Oral immunotherapy shortens the duration of milk and egg allergy - the con argument

Wenyin Loh  1   2 , Mimi L K Tang  1   3   4
Affiliations

Debates in Allergy Medicine: Oral immunotherapy shortens the duration of milk and egg allergy - the con argument

Wenyin Loh et al. World Allergy Organ J. .

Abstract

Oral immunotherapy (OIT) has been shown to be effective for inducing desensitization in children with cow's milk and egg allergy. In contrast, there is limited evidence that OIT can induce tolerance or sustained unresponsiveness in food allergic patients. Sustained unresponsiveness, determined by a food challenge following a period of secondary avoidance, has been suggested to reflect a more enduring state of tolerance and is pertinent when considering the ability of OIT to shorten the duration of food allergy. While it has been shown that children who tolerate baked forms of egg and milk are more likely to develop tolerance compared to those who are allergic to baked forms of these foods, there is no convincing evidence that OIT using modified allergen in baked foods can hasten resolution of cow's milk and egg allergy. Instead, it is likely that baked milk and baked egg tolerant children represent a sub-phenotype of milk and egg allergy that is more likely to resolve spontaneously over time.

Keywords: Desensitization; Egg; Food allergy; Milk; Oral immunotherapy; Sustained unresponsiveness; Tolerance.

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Conflict of interest statement

Not applicable.MLK Tang is a member of the Medical Advisory Board Oceania for Nestle Nutrition Institute; a past member of Global Scientific Advisory Board, Danone Nutricia; employee of and holding share options/interest in Prota Therapeutics; inventor on a patent owned by The Murdoch Children’s Research Institute; presenter at seminars sponsored by Danone Nutricia and Nestle Health Science. W Loh has no conflicts of interest to disclose.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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