Low-Dose Oral Immunotherapy Using Low-Egg-Allergen Cookies for Severe Egg-Allergic Children Reduces Allergy Severity and Affects Allergen-Specific Antibodies in Serum

Background: We evaluated the safety and efficacy of low-egg-allergen cookies (LAC) as low-dose oral immunotherapy (OIT) in children with severe egg allergy. We also examined the relationship between mild desensitization by low-dose OIT and serum biomarkers of allergy. Methods: We enrolled 13 children with egg allergy who could not receive OIT with hard-boiled egg white (EW). For 11 participants, OIT was carried out using LAC for 3-4 months. Open food challenges with hard-boiled EW and blood samplings were performed before and after OIT. Participants were divided into 2 groups: high effect (H-E) and no/low effect (N/L-E). Serum levels of total IgE and egg yolk-, EW-, and ovomucoid (OM)-specific IgE, ovalbumin (OVA)- and OM-specific IgG₄, IgA₁, and IgA₂, and the percentage of CD 203c⁺ were measured. Results: Allergic severity was reduced in 7 patients, who were assigned to the H-E group. Moreover, no study participants were taken off the intake of LAC during OIT. In the H-E group, OVA-specific IgA₂ levels after OIT were significantly higher than before OIT. The ratios of OM-specific IgG₄/OM-specific IgE and OM-specific IgA₂/OM-specific IgE in the H-E group after OIT were significantly higher than before OIT. Conclusion: Our findings suggest that low-dose OIT using LAC is an effective and safe treatment for patients with severe egg allergy.
Int Arch Allergy Immunol

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