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Allergol Int. 2018 Apr;67(2):209-216. doi: 10.1016/j.alit.2017.07.007. Epub 2017 Aug 1.

Desensitization to a whole egg by rush oral immunotherapy improves the quality of life of guardians: A multicenter, randomized, parallel-group, delayed-start design study.

Author information

1
Department of Pediatrics, Shimoshizu National Hospital, Chiba, Japan.
2
Department of Pediatrics, Eastern Chiba Medical Center, Chiba, Japan; Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba, Japan. Electronic address: yuzaburo@chiba-u.jp.
3
Allergy Center, Mie National Hospital, Mie, Japan.
4
Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan.
5
Allergy Center, Mie National Hospital, Mie, Japan; Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Saitama, Japan.

Abstract

BACKGROUND:

Patients with food allergies and their families have a significantly reduced health-related quality of life (QOL).

METHODS:

We performed a multicenter, randomized, parallel-group, delayed-start design study to clarify the efficacy and safety of rush oral immunotherapy (rOIT) and its impact on the participants' daily life and their guardians (UMIN000003943). Forty-five participants were randomly divided into an early-start group and a late-start group. The early-start group received rOIT for 3 months, while the late-start group continued the egg elimination diet (control). In the next stage, both groups received OIT until all participants had finished 12 months of maintenance OIT.

RESULTS:

The ratio of the participants in whom an increase of the TD was achieved in the first stage was significantly higher in the early-start group (87.0%), than in the late-start group (22.7%). The QOL of the guardians in the early-start group significantly improved after the first stage (65.2%), in comparison to the late-start group (31.8%). During 12 months of rOIT, the serum ovomucoid-specific IgE levels, the percentage of CD203c+ basophils upon stimulation with egg white, and the wheal size to egg white were decreased, while the serum ovomucoid-specific IgG4 levels were increased. However, approximately 80% of the participants in the early-start group showed an allergic reaction during the first stage of the study, whereas none of the patients in the late-start group experienced an allergic reaction.

CONCLUSIONS:

rOIT induced desensitization to egg and thus improved the QOL of guardians; however, the participants experienced frequent allergic reactions due to the treatment.

KEYWORDS:

Desensitization; Food allergy; Guardians; Oral immunotherapy; Quality of life

PMID:
28778455
DOI:
10.1016/j.alit.2017.07.007
[Indexed for MEDLINE]
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