Induction of Tolerance in Children with Food Allergy

Abstract

Food allergies are more prevalent during childhood. Relativity few foods are responsible for the vast majority of significant food-induced allergic reactions: milk, egg, peanuts, tree nuts, fish and selfish. The prognosis of these food allergies is not always toward spontaneous tolerance. Predictive factors of not developing spontaneous tolerance were: high levels of specific IgE to food proteins, allergic rhinitis and asthma. To date, the only treatment for food allergies has been to eliminate the offending food from the diet. In recent years, a number of studies have been published regarding desensitization or tolerance induction to food, particularly to cow milk and egg, as an alternative treatment in patients who have not developed spontaneous tolerance. This is a review of the different studies of induction of tolerance with different type of foods and protocols. Oral induction of tolerance appears to be effective in induced short-term desensitization and to be quite safe, but further research is needed using large, high- quality studies that investigate and assesses the long-term efficacy, safety and cost-effectiveness of the induction of oral tolerance. Keywords: Desensitization, food allergy, immunotherapy, induction, tolerance treatment, long-term efficacy, IgE-mediated mechanisms, non-IgE-mediated (cellular) mechanisms, hypersensitivity