a Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
b Samitivej Allergy Institute (SAI), Samitivej Thonburi Hospital , Bangkok , Thailand.
Hum Vaccin Immunother. 2017 Oct 3;13(10):2462-2466. doi: 10.1080/21645515.2017.1356499.
Among various routes of immunotherapy for food allergy, oral immunotherapy (OIT) appears to have a promising result due to its ability to modify abnormal immunologic mechanism of IgE-mediated food allergy. Other methods for immunomodulation such as sublingual (SLIT) or epicutaneous (EPIT) immunotherapy which carry lower rates of systemic reactions, may have less efficacy. Wheat has recently been recognized as a more common cause of food-induced anaphylaxis than previously recognized, especially among young children, around the world. In wheat allergic patients, avoidance recommended as standard recommendation is not easy to follow, because wheat has been used as a common constituents in various kinds of consumed foods in every day's life. Therefore, wheat OIT may be considered as an alternative treatments of those in which wheat avoidance is not sufficient to avert frequent events of anaphylaxis resulting from inadvertent exposure to small amount of wheat among this population. Currently, only few clinical trials about wheat OIT are available. In this review, we discuss available protocols of wheat OIT, initial starting dose, maintenance dose, and the strategies to minimize the side effects during the treatment.
在各种食物过敏的免疫治疗途径中，口服免疫疗法（OIT）因其能够改变 IgE 介导的食物过敏的异常免疫机制，似乎具有广阔的前景。其他免疫调节方法，如舌下（SLIT）或经皮（EPIT）免疫疗法，全身性不良反应发生率较低，但疗效可能较低。小麦最近被认为比以前更常见于食物诱发的过敏反应，尤其是在全世界的幼儿中。在小麦过敏患者中，建议避免作为标准推荐，但不容易遵循，因为小麦已被用作日常生活中各种食用食品的常见成分。因此，小麦 OIT 可能被认为是那些因无意中摄入少量小麦而导致过敏反应频繁发生，无法避免的患者的替代治疗方法。目前，关于小麦 OIT 的临床试验很少。在这篇综述中，我们讨论了小麦 OIT 的可用方案、起始剂量、维持剂量以及在治疗过程中减少副作用的策略。
