a Department of Pediatrics , Takatsuki General Hospital , Osaka , Japan.
b Department of Pediatrics , Kansai Medical University , Osaka , Japan.
Hum Vaccin Immunother. 2017 Oct 3;13(10):2443-2451. doi: 10.1080/21645515.2017.1353845.
Oral immunotherapy (OIT) is used regularly for young children with cow's milk (CM) allergy and has been shown to be effective in several studies. However, adverse events occur frequently during OIT. Furthermore, there are only 5 randomized controlled trial studies of CM-OIT and these are low-powered single center trials. Therefore, evidence levels are also low and sometimes frequent and severe allergic events occur during the OIT. Furthermore, there are no standardized protocols in pediatric allergy guidelines from several countries and studies with long-term follow-up observations and clinical tolerance defined as sustained unresponsiveness are rare. Additionally, clinical tolerance by OIT is generally not well defined and obscure. Thus, several problems remain to be resolved, however we hope OIT in combination with omalizumab and less allergenic heated CM products will resolve these problems in the future.
口服免疫疗法（OIT）常用于治疗儿童牛奶（CM）过敏，多项研究表明其具有一定疗效。然而，OIT 期间常发生不良反应事件。此外，仅有 5 项 CM-OIT 的随机对照试验研究，且这些研究的效力较低，为单一中心试验。因此，证据级别也较低，有时 OIT 期间会频繁发生严重过敏反应事件。此外，来自多个国家的儿科过敏指南中没有标准化方案，并且很少有长期随访观察和临床耐受（定义为持续无反应）的研究。此外，OIT 的临床耐受通常没有明确界定，比较模糊。因此，仍有一些问题需要解决，但我们希望 OIT 与奥马珠单抗和低变应原加热 CM 产品相结合，将在未来解决这些问题。
