Allergy Unit, Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy.
Curr Opin Allergy Clin Immunol. 2011 Dec;11(6):560-4. doi: 10.1097/ACI.0b013e32834cd298.
The purpose of this review is to research current evidence on cow's milk oral immunotherapy for the treatment of cow's milk allergy (CMA).
The specific, active treatment for IgE-mediated food allergy included CMA, which is currently being investigated in human trials. Allergen-specific approaches include oral, sublingual and epicutaneous immunotherapy. Reports on oral immunotherapy (OIT) for the treatment of milk allergy have been more extensive and carried out mostly with native proteins. The aim of OIT with cow's milk is the achievement of desensitization or tolerance by patients suffering from CMA. Desensitization state can be achieved by approximately 36-92% of the children treated with specific immunotherapy; the rate of permanent tolerance is unknown. Longer duration of desensitization may result in permanent tolerance. The possibility of adverse events or reactions during OIT is quite frequent. Side-effects have been reported by patients in all published studies.
OIT as an active treatment for CMA represents an emerging reality. Before this treatment can be used in clinical practice, additional studies are needed. Currently, many issues remain unanswered: severity and type of food allergy responsive to specific immunotherapy, degree of protection, 'shared schedules' of desensitization(s) in research settings and well established risk-to-benefit ratio. However the field of specific, active treatment of food allergy is poised for clinically important advances.
本综述旨在研究目前关于牛奶口服免疫疗法治疗牛奶过敏（CMA）的证据。
针对 IgE 介导的食物过敏的特异性、主动治疗包括 CMA，目前正在人类试验中进行研究。过敏原特异性方法包括口服、舌下和经皮免疫疗法。关于牛奶过敏的口服免疫疗法（OIT）的报告更为广泛，并且主要使用天然蛋白进行。OIT 治疗牛奶过敏的目的是使患有 CMA 的患者达到脱敏或耐受状态。通过特异性免疫治疗，约有 36-92%的患者可以达到脱敏状态；永久性耐受的比率尚不清楚。脱敏时间较长可能导致永久性耐受。OIT 期间发生不良反应或反应的可能性相当频繁。所有已发表的研究都报告了患者出现的副作用。
OIT 作为 CMA 的主动治疗代表了一种新出现的现实。在这种治疗可以在临床实践中使用之前，还需要进行额外的研究。目前，仍有许多问题尚未得到解答：对特异性免疫治疗有反应的食物过敏的严重程度和类型、保护程度、研究环境中脱敏的“共享方案”以及既定的风险-效益比。然而，食物过敏的特异性、主动治疗领域正准备取得临床重要进展。
