Oral immunotherapy (OIT) is a godsend for many families where avoidance is not a viable or reliable option, especially in children. The therapy is gaining popularity for the treatment of allergies to such foods as peanuts, tree nuts, milk, and eggs.
With much less known about the effectiveness of OIT for wheat allergy, a report published in Pediatric Allergy and Immunology provides some early insight.
Researchers from the Department of Pediatrics, Jikei University School of Medicine, Tokyo and Sagamihara National Hospital, Kanagawa, recruited children aged 5-18 years with a history of wheat allergy that was subsequently confirmed with an oral food challenge (OFC).
During a 5-day admission to the hospital, the 16-child immunotherapy cohort was given a small amount of wheat protein that was gradually increased to 53mg/day. The children were then sent home where they continued to ingest a 53mg dose of wheat protein daily for one year. Another 11-child control cohort was instructed to avoid wheat for the year.
At the conclusion of the study, the OIT cohort ceased their intake of wheat protein for two weeks followed by an oral food challenge where they were given 53mg and 400mg of wheat protein. The control group was challenged as well.
Within the year, 88% of patients in the OIT group reached 53mg. After 1 year, 69% passed the 53mg challenge compared to 9% in the control group. 25% passed the 400mg challenge compared to 0% in the control group.
There were 7 instances of anaphylaxis during the trial that improved without the use of epinephrine.
The researchers concluded that for patients with wheat anaphylaxis, low‐dose OIT safely induces immunologic changes, achieves low‐dose desensitization, and may allow for a 400mg dose.