Purpose of review: Food allergy is a common disease in childhood. Natural tolerance development is frequent, but some children with cow's milk or hen's egg allergy and the majority of children with peanut allergy will remain allergic until adulthood. Within the last several years, the usefulness of oral immunotherapy has been investigated in food allergic patients. This review covers the most recent findings.
Recent findings: In cow's milk and hen's egg allergy, controlled trials have been conducted in children, showing that oral immunotherapy, in general, has been successful and safe. Moreover, rush protocols have been developed allowing desensitization in a short period of time. Although side effects are frequent, allergic reactions seem to be controllable by antihistamines, steroids, or epinephrine. For peanut allergy, the first results look promising and detailed data will be available shortly.
Summary: Several studies have shown that oral immunotherapy is a promising approach, especially in patients with severe and persistent food allergy. Side effects are frequent but seem controllable. So far, treatment protocols have been performed in highly supervised research settings. Until more experience is gained from larger long-term studies, oral immunotherapy should not be tried in clinical practice settings.