Food Allergy Immunotherapy (OIT)
Oral Immunotherapy to food was first described in 1908 in the Lancet - a case of egg poisoning’ - by a physician practising in Harley Street (pre NHS). This report (open access on the link above) is extremely informative and reflects the process of OIT rather well, where even very allergic patients can enjoy a rise in the threshold of the allergen to which they are allergic.
OIT to foods has enjoyed a massive leap forward thanks to the rigorous, extensive international studies (Palisade & Artemis) that underpin the licensing of a peanut OIT product.
Thanks to these studies, we now understand the best regimens and products for successful OIT and the likely associated risks and side effect profiles.
We now offer OIT in our Allergy Centre of Excellence.
Please be aware of the following principles when considering an OIT program:
OIT is not curative, i.e. for most allergens, ongoing therapy is required to ensure tolerance.
Whether OIT to baked egg and milk ‘hurries up’ the process of developing natural tolerance to all eggs and milk is controversial. Still, it has been associated with increased QOL in those eating these baked foods (unsurprisingly).
OIT seeks to raise the threshold at which a reaction would occur, aiming to render your child ‘bite proof’ i.e. protected from accidental every day exposures.
OIT is allergen-specific and protects only against the allergen that is eaten (perhaps with the exception of cashew and walnut, where protection may also be enjoyed for pistachio and pecan nuts, respectively).
Side effects on OIT are common and usually affect the GI system
More severe allergic side effects can occur, sometimes unpredictably, i.e. after months of tolerance. This can arise due to co-factors such as exercise, infections, and medication use.
Emergency medication will, therefore, always be required on your person while undergoing OIT.
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Please feel free to discuss advances in the field and the potential for OIT for your child when consulting with Prof du Toit. Prof Du Toit has been an investigator on many of these trials and is actively involved in research testing other treatment modalities e.g. Viaskin trials. Here are some links around the topic that will hopefully be of interest.
