Department of Paediatrics, Fatebenefratelli Hospital, Benevento, Italy.
Pediatr Allergy Immunol. 2013 Feb;24(1):66-74. doi: 10.1111/j.1399-3038.2012.01349.x. Epub 2012 Sep 9.
Treatment of severe egg allergy is avoidance of hen's egg (HE) and carrying self-injectable epinephrine. Specific oral tolerance induction (SOTI) seems a promising alternative treatment. However, some aspects of SOTI are still considered experimental.
We evaluated the efficacy and safety of an original 6-month SOTI protocol in children with very severe HE allergy using raw HE emulsion. Twenty children (age range: 5-11 yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6 months later. Control children were kept on an egg-free diet for 6 months and then underwent a second challenge.
After 6 months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10 ml, but <40 ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5 ml (no tolerance). After 6 months, nine control children tested positive to the second challenge at a dose ≤0.9 ml of raw HE emulsion, and one reacted to 1.8 ml (SOTI vs. control group p<0.0001). All children in the SOTI group had side effects, but no child had a grade 5 reaction according to the Sampson grading.
Six months of SOTI with raw HE emulsion resulted in partial tolerance, with regular intake, in a significant percentage of children with severe egg allergy.
治疗严重鸡蛋过敏症的方法是避免食用鸡蛋（HE）并携带自我注射肾上腺素。特异性口服免疫耐受诱导（SOTI）似乎是一种很有前途的替代治疗方法。然而，SOTI 的某些方面仍被认为是实验性的。
我们使用生鸡蛋乳液评估了一种原始的 6 个月 SOTI 方案在严重 HE 过敏儿童中的疗效和安全性。20 名年龄在 5-11 岁的儿童被随机分为 SOTI 治疗组和对照组。治疗组开始 SOTI，并在 6 个月后进行第二次挑战。对照组的儿童在 6 个月内保持无蛋饮食，然后进行第二次挑战。
6 个月后，SOTI 组的 10 名儿童中有 9 名（90%）实现了部分耐受（至少 10ml，但<40ml 生鸡蛋乳液，单次剂量），1 名（10%）仅能耐受 5ml（无耐受）。6 个月后，9 名对照儿童在接受生鸡蛋乳液剂量≤0.9ml 的第二次挑战时呈阳性反应，1 名反应至 1.8ml（SOTI 组与对照组 p<0.0001）。SOTI 组的所有儿童均出现副作用，但根据 Sampson 分级，无 1 名儿童出现 5 级反应。
生鸡蛋乳液 SOTI 治疗 6 个月可使严重鸡蛋过敏儿童的大部分儿童实现部分耐受，且定期摄入。
