Egg OIT Helps More Children Achieve Sustained Unresponsiveness Than Baked Egg

The American College of Allergy, Asthma and Immunology estimates that as many as 2% of children are allergic to eggs, and some 70% of them will outgrow their condition by age 16. That leaves a sizable number allergic to a very common food used in many packaged food products.

Some that are allergic to egg can tolerate baked egg while others react to eggs regardless of how they are used or prepared. Often those that can tolerate baked egg are encouraged to consume products that contain them so as to retain their unresponsiveness to baked egg and achieve sustained unresponsiveness to all eggs.

The Southern California Food Allergy Institute defines sustained unresponsiveness as a state where the introduction of large, infrequent doses of an allergen will no longer elicit a response from a person’s immune system.

The question then is whether consuming baked egg (BE) is as effective as undergoing egg oral immunotherapy (OIT) to achieve sustained unresponsiveness.

A small study published in the Journal of Allergy and Clinical Immunology sought to answer this very question.

Researchers enrolled 50 children three to 16 years of age who were BE-tolerant but reactive to unbaked eggs and randomized them into two cohorts: one would receive two years of BE therapy while the other would receive traditional egg OIT. After the first and second years, the children received double-blind, placebo-controlled food challenges to determine their desensitization. After the second year, the children then had a period of eight to ten weeks without their respective treatments and were administered another food challenge.

Simultaneously, 39 children who were reactive to baked egg were given egg OIT as a comparator group.

They found that 3 of the 27 baked egg cohort achieved sustained unresponsiveness while 10 of the 23 in the egg OIT group and 7 of the 39 in the comparator group did. Dosing symptom frequency in participants who were BE-tolerant was similar with BE and egg OIT, but more frequent in participants who were BE-reactive. Egg white–specific IgE, skin testing, and basophil activation decreased similarly after BE and egg OIT.

The researchers concluded that among children allergic to unbaked egg but tolerant to baked egg, those treated with egg OIT were significantly more likely to achieve SU than were children ingesting baked egg to achieve sustained unresponsiveness.