Huang Jenny, Puglisi Leah H, Cook Kevin A, Kelso John M, Wangberg Hannah
Division of Allergy, Asthma, and Immunology, Scripps Clinic, San Diego, Calif.
Scripps Department of Research & Development, Scripps Health, San Diego, Calif.
J Allergy Clin Immunol Pract. 2025 Jan;13(1):185-191.e3. doi: 10.1016/j.jaip.2024.09.025. Epub 2024 Sep 30.
Oral immunotherapy (OIT) for food allergy has been largely studied in older children within the context of clinical trials, and its availability has historically been limited for younger patients with food allergy. Data have shown that the most impact may actually be seen with the use of OIT in younger infants and toddlers.
To evaluate the safety and feasibility of OIT in subjects 24 months and younger in a real-world setting using commercially available food products.
This was a retrospective study of subjects 24 months and younger initiated on OIT for peanut, tree nut, or sesame allergy within the Scripps Clinic allergy department. Medical records were reviewed for data regarding initial oral food challenges, OIT, and adverse outcomes.
Fifty-two subjects 24 months and younger were initiated on OIT. Most subjects (84.6%) were on single-food OIT, and some (15.4%) were on multifood OIT. No increased adverse outcomes were observed on multifood OIT. Of the 59 initial oral food challenges, objective reactions occurred during 42 challenges, most being low-grade reactions. During initial oral food challenges, 86.1% of peanut-allergic children tolerated 1/8 of 1 Bamba stick with no reaction. Most subjects (73.1%) updosed at home, and most (51.9%) had no reactions while updosing. Some had low-grade cutaneous reactions, none requiring epinephrine or emergency evaluation.
OIT in infants is safe and feasible to perform in a real-world setting using commercially available food products with at-home updosing, thus increasing the availability of OIT for patients.
食物过敏的口服免疫疗法（OIT）在临床试验背景下已在大龄儿童中得到广泛研究，而对于年龄较小的食物过敏患者，其应用历史上一直有限。数据表明，在较小的婴幼儿中使用OIT可能实际产生最大影响。
在现实环境中，使用市售食品评估24个月及以下受试者OIT的安全性和可行性。
这是一项对斯克里普斯诊所过敏科内开始接受花生、坚果或芝麻过敏OIT治疗的24个月及以下受试者的回顾性研究。对病历进行审查，以获取有关初始口服食物激发试验、OIT和不良结局的数据。
52名24个月及以下的受试者开始接受OIT治疗。大多数受试者（84.6%）接受单一食物OIT，一些受试者（15.4%）接受多种食物OIT。多种食物OIT未观察到不良结局增加。在59次初始口服食物激发试验中，42次激发试验期间出现了客观反应，大多数为轻度反应。在初始口服食物激发试验期间，86.1%的花生过敏儿童耐受1/8根Bamba棒且无反应。大多数受试者（73.1%）在家中增加剂量，大多数（51.9%）在增加剂量时无反应。一些受试者有轻度皮肤反应，均无需使用肾上腺素或进行紧急评估。
在现实环境中，使用市售食品并在家中增加剂量对婴儿进行OIT是安全可行的，从而增加了OIT对患者的可及性。
