Oral Immunotherapy in Patients with IgE Mediated Reactions to Egg White: A Clinical Trial Study

ABSTRACT

Background

Oral immunotherapy (OIT) is under consideration as a promising treatment for desensitization of egg-allergic patients. The objective of this study was to assess the effectiveness of egg-white OIT in patients with IgE-mediated allergy to egg white and to compare the clinical and laboratory findings before and after OIT.

Methods

This clinical trial was performed from February to August 2018 in Rasool e Akram Hospital, Tehran, Iran. Patients’ selection criteria included a history of allergic symptoms, skin prick test (SPT) reactivity to egg white, and the inability to pass the Oral Food Challenge (OFC). Egg-white OIT was done for eight patients in the OIT group for 6 months while egg-white-free products were administrated for controls. The SPT reactivity, specific IgE, and IgG4 for egg white and ovomucoid were evaluated before and after OIT.

Results

Hundred percent of the subjects in OIT group were desensitized and tolerated 40 cc raw egg white following 6-month maintenance whereas none of the controls was able to pass the OFC. The findings obtained from the evaluations indicated a significant decrease in the wheal size and specific IgE to egg white after OIT (P = .001). Furthermore, a significant decrease of IgE/IgG4 ratio to egg white was found in OIT group (P = .01).

Conclusion

This OIT protocol was successful as all OIT patients were able to continue 6-month OIT process and the reaction threshold to egg white increased in the OIT group. Therefore, it could be regarded as an effective and safe protocol to treat egg-allergic patients.

KEYWORDS:

• Egg allergy
• oral immunotherapy
• egg anaphylaxis
• oral desensitization

Acknowledgments

This article was retrieved from a fellowship thesis and was supported by Iran University of Medical sciences.

Disclosure statement

Authors declare they have no conflict of interest.

Ethics Statement

This study was approved by the ethics committee of Iran University of Medical Sciences (IR.IUMs.FMD.REC1396.9311568002) and registered in Iranian Registry of Clinical Trials (IRCT20180116038387N1).

Additional information

Funding

This work was supported by the Iran University of Medical Sciences.