Food allergy: Trends in the development of allergen-specific immunotherapy technologies

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: Food allergy is an urgent problem for public health around the world. One of the most promising methods of food allergy treatment is allergen-specific immunotherapy.

AIM: to analyze the results of clinical studies on the effectiveness and safety of modern allergen-specific immunotherapy technologies in the treatment of food allergies published over the past three years.

MATERIALS AND METHODS: A search and analysis of scientific publications was carried out using resources cataloging biomedical scientific literature: PubMed and eLibrary. The review includes original studies published between January 1, 2020 and December 31, 2022.

RESULTS: The review made it possible to systematize the data accumulated over the past three years, reflecting the main trends in allergen-specific immunotherapy of food allergy. The analysis of studies showed modern approaches to oral and epicutaneous immunotherapy and affected the efficacy and safety of these types of treatment. In food allergy cohorts, the allergen-specific immunotherapy approach of oral and epicutaneous allergen-specific immunotherapy has been shown to be highly effective in achieving tolerance and desensitization to the food trigger it was revealed that epicutaneous allergen-specific immunotherapy is characterized by a high level of adherence of patients to treatment.

CONCLUSION: It is necessary to continue conducting large-scale clinical studies on modern methods of allergen-specific immunotherapy in patients with food allergies to form standardized therapy protocols.

About the authors

Ulyana V. Kutas

Siberian State Medical University

Author for correspondence.
Email: uliaka007@gmail.com
ORCID iD: 0000-0003-3495-0832
SPIN-code: 3201-5750
Russian Federation, Tomsk

Valeria D. Prokopyeva

Siberian State Medical University

Email: valeriya.d.prokopyeva@gmail.com
ORCID iD: 0000-0002-0728-5825
SPIN-code: 1072-4300
Russian Federation, Tomsk

Marina M. Fedotova

Siberian State Medical University

Email: fedotova.letter@gmail.com
ORCID iD: 0000-0001-7655-7911
SPIN-code: 1488-8189

MD, Cand Sci (Med.), Assistant Professor

Russian Federation, Tomsk

Olga S. Fedorova

Siberian State Medical University

Email: fedorova.os@ssmu.ru
ORCID iD: 0000-0002-7130-9609
SPIN-code: 5285-4593

MD, Dr. Sci. (Med.), Professor

Russian Federation, Tomsk

References

  1. Elghoudi A, Narchi H. Food allergy in children: The current status and the way forward. World J Clin Pediatr. 2022;11(3):253–269. doi: 10.5409/wjcp.v11.i3.253
  2. Peters RL, Barret DY, Soriano VX, et al. No cashew allergy in infants introduced to cashew by age 1 year. J All Clin Immunol. 2021;147(1):383–384. doi: 10.1016/j.jaci.2020.07.003
  3. Bilaver LA, Chadha AS, Doshi P, et al. Economic burden of food allergy. Ann Allergy Asthma Immunol. 2019;122(4):373–380. doi: 10.1016/j.anai.2019.01.014
  4. Muraro A, Werfel T, Hoffmann-Sommergruber K, et al. The EAACI food allergy and anaphylaxis guidelines group EAACI food allergy and anaphylaxis guidelines: Diagnosis and management of food allergy. Allergy. 2014;69(8):1008–1025. doi: 10.1111/all.12429
  5. Schoos AM, Bullens D, Chawes BL, et al. Immunological outcomes of allergen-specific immunotherapy in food allergy. Front Immunol. 2020;(11):568598. doi: 10.3389/fimmu.2020.568598
  6. Nurmatov U, Dhami S, Arasi S, et al. Allergen immunotherapy for IgE-mediated food allergy: A systematic review and meta-analysis. Allergy. 2017;72(8):1133–1147. doi: 10.1111/all.13124
  7. Savilahti EM, Saarinen KM, Savilahti E. Cow’s milk allergy and the development of tolerance. Eur J Nutr. 2010;49(8):501–504. doi: 10.1007/s00394-010-0109-8
  8. Kim KS, Surh CD. Induction of immune tolerance to dietary antigens. Adv Exp Med Biol. 2015;(850):93–118. doi: 10.1007/978-3-319-15774-0_8
  9. Anagnostou K, Stiefel G, Brough H, et al. Active management of food allergy: An emerging concept. Arch Dis Childhood. 2015;100(4):386–390. doi: 10.1136/archdischild-2014-306278
  10. Halken S, Larenas-Linnemann D, Roberts G, et al. EAACI guidelines on allergen immunotherapy: Prevention of allergy. Pediatr All Immunol. 2017;28(8):728–745. doi: 10.1111/pai.12807
  11. Nwaru BI, Hickstein L, Panesar SS, et al. The EAACI food allergy and anaphylaxis guidelines group prevalence of common food allergies in Europe: A systematic review and meta-analysis. Allergy. 2014;69(8):992–1007. doi: 10.1111/all.12423
  12. Renz H, Allen KJ, Sicherer SH, et al. Food allergy. Nat Rev Dis Primers. 2018;(4):17098. doi: 10.1038/nrdp.2017.98
  13. Grabenhenrich LB, Dolle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: The European anaphylaxis registry. J All Clin Immunol. 2016;137(4):1128–1137.e1. doi: 10.1016/j.jaci.2015.11.015
  14. Baseggio CA, Ierodiakonou D, Gowland MH, et al. Food anaphylaxis in the United Kingdom: Analysis of national data, 1998–2018. BMJ. 2021;(372):n251. doi: 10.1136/bmj.n251
  15. Vickery BP, Vereda A, Casale TB, et al.; PALISADE Group of Clinical Investigators. AR101 oral immunotherapy for peanut allergy. New Eng J Med. 2018;379(21):1991–2001. doi: 10.1056/NEJMoa1812856
  16. Fernandez-Rivas M, Vereda A, Vickery BP, et al. Open-label follow-on study evaluating the efficacy, safety, and quality of life with extended daily oral immunotherapy in children with peanut allergy. Allergy. 2022;77(3):991–1003. doi: 10.1111/all.15027
  17. Highlights of prescribing information [Internet]. PALFORZIA [Peanut (Arachis hypogaea) Allergen Powder-dnfp] Powder for oral administration Initial U.S. Approval: 2020. [cite 07/2022]. Available from: https://www.fda.gov/media/134838/download. Accessed: 15.08.2023.
  18. Ciaccio C, Goldsobel AB, Anagnostou A, et al. Participant characteristics and safety outcomes of peanut oral immunotherapy in the RAMSES and ARC011 trials. Ann Allergy Asthma Immunol. 2022;129(6):758–768. doi: 10.1016/j.anai.2022.07.033
  19. Grzeskowiak LE, Tao B, Knight E, et al. Adverse events associated with peanut oral immunotherapy in children: A systematic review and meta-analysis. Sci Rep. 2020;10(1):659. doi: 10.1038/s41598-019-56961-3
  20. Tice JA, Guzauskas GF, Hansen RN, et al. The effectiveness and value of oral immunotherapy and viaskin peanut for peanut allergy. J Manag Care Spec Pharm. 2020;26(5):620–623. doi: 10.18553/jmcp.2020.26.5.620
  21. Hill DJ, Firer MA, Shelton MJ, Hosking CS. Manifestations of milk allergy in infancy: Clinical and immunologic findings. J Pediatr. 1986;109(2):270–276. doi: 10.1016/s0022-3476(86)80384-5
  22. Fiocchi A, Schunemann HJ, Brozek J, et al. Diagnosis and rationale for action against cow’s milk allergy (DRACMA): A summary report. J Allergy Clin Immunol. 2010;126(6):1119–1128. doi: 10.1016/j.jaci.2010.10.011
  23. Venter C, Meyer R, Ebisawa M, et al. Food allergen ladders: A need for standardization. Pediat Allergy Immunol. 2022;33(1):e13714. doi: 10.1111/pai.13714
  24. Dunn GA, Cullinane C, Daly DA, et al. Longitudinal validity and responsiveness of the food allergy quality of life questionnaire: Parent form (FAQLQ-PF) in children 0–12 years following positive and negative food challenges. Clin Exp Allergy. 2010;40(3):476–485. doi: 10.1111/J.1365-2222.2010.03454
  25. Venter С, Brown T, Shah N, et al. Diagnosis and management of non-IgE-mediated cow’s milk allergy in infancy: A UK primary care practical guide. Clin Transl Allergy. 2013;3(1):23. doi: 10.1186/2045-7022-3-23
  26. Nowak-Wegrzyn A, Bloom KA, Sicherer SH, et al. Tolerance to extensively heated milk in children with cow’s milk allergy. J Allergy Clin Immunol. 2008;122(2):342–347. doi: 10.1016/j.jaci.2008.05.043
  27. D’Art YM, Forristal L, Byrne AM, et al. Single low-dose exposure to cow’s milk at diagnosis accelerates cow’s milk allergic infants’ progress on a milk ladder programme. Allergy. 2022;77(9): 2760–2769. doi: 10.1111/все.15312
  28. Savage JH, Matsui EC, Skripak JM, et al. The natural history of egg allergy. J Allergy Clin Immunol. 2007;120(6):476–485. doi: 10.1111/j.1365-2222.2010.03454.x
  29. Toit GD, Foong RM, Lack G. Prevention of food allergy: Early dietary interventions. Allergol Int. 2016;65(4):370–377. doi: 10.1016/j.alit.2016.08.001
  30. Fedotova MM, Fedorova OS, Konovalova UV, et al. Food allergy to chicken egg: A review of modern research. Bulletin Siberian Med. 2018;17(2):156–166. (In Russ). doi: 10.20538/1682-0363-2018-2-156-166
  31. Kim EH, Perry TT, Wood RA, et al. Induction of sustained unresponsiveness after egg oral immunotherapy compared to baked egg therapy in children with egg allergy. J Allergy Clin Immunol. 2020;146(4):851–862. doi: 10.1016/j.jaci.2020.05.040
  32. Kim EH, Jones SM, Burks AW, et al. A 5-year summary of real-life dietary egg consumption after completion of a 4-year egg powder oral immunotherapy (eOIT) protocol. J Allergy Clin Immunol. 2020;145(4):1292–1295. doi: 10.1016/j.jaci.2019.11.045
  33. Sugiura S, Kitamura K, Makino A, et al. Slow low-dose oral immunotherapy: Threshold and immunological change. Allergol Int. 2020;69(4):601–609. doi: 10.1016/j.alit.2020.03.008
  34. Dana VG, Fallahpour M, Shoormasti RS, et al. Oral immunotherapy in patients with IgE mediated reactions to egg white: A clinical trial study. Immunol Invest. 2022;51(3):630–643. doi: 10.1080/08820139.2020.1863979
  35. Ricci G, Andreozzi L, Cipriani F, et al. Wheat allergy in children: A comprehensive update. Medicina. 2019;55(7):400. doi: 10.3390/medicina55070400
  36. Zuidmeer L, Goldhahn K, Rona RJ, et al. The prevalence of plant food allergies: A systematic review. J Allergy Clin Immunol. 2008;121(5):1210–1218.e4. doi: 10.1016/j.jaci.2008.02.019
  37. Ostblom E, Lilja G, Ahlstedt S, et al. Patterns of quantitative food-specific IgE-antibodies and reported food hypersensitivity in 4-year-old children. Allergy. 2008;63(4):418–424. doi: 10.1111/j.1398-9995.2007.01575.x
  38. Fleischer DM, Perry TT, Atkins D, et al. Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study. Pediatr. 2012;130(1):e25–32. doi: 10.1542/peds.2011-1762
  39. Nagakura KI, Yanagida N, Sato S, et al. Low-dose-oral immunotherapy for children with wheat-induced anaphylaxis. Pediatr Allergy Immunol. 2020;31(4):371–379. doi: 10.1111/pai.13220
  40. Dioszeghy V, Mondoulet L, Dhelft V, et al. The regulatory T cells induction by epicutaneous immunotherapy is sustained and mediates long-term protection from eosinophilic disorders in peanut-sensitized mice. Clin Exp Allergy. 2014;44(6):867–881. doi: 10.1111/cea.12312
  41. Dupont C, Kalach N, Soulaines P, et al. Cow’s milk epicutaneous immunotherapy in children: A pilot trial of safety, acceptability, and impact on allergic reactivity. J Allergy Clin Immunol. 2010;125(5):1165–1167. doi: 10.1016/j.jaci.2010.02.029
  42. Jones SM, Agbotounou WK, Fleischer DM, et al. Safety of epicutaneous immunotherapy for the treatment of peanut allergy: A phase 1 study using the Viaskin Patch. J Allergy Clin Immunol. 2016;137(4):1258–1261. doi: 10.1016/j.jaci.2016.01.008
  43. Stacie MJ, Sicherer SH, Burks AW, et al. Epicutaneous immunotherapy for the treatment of peanut allergy in children and young adults. J Allergy Clin Immunol. 2017;139(4):1242–1252.e9. doi: 10.1016/j.jaci.2016.08.017
  44. Scurlock AM, Burks AW, Sicherer SH, et al. Epicutaneous immunotherapy for treatment of peanut allergy: Follow-up from the consortium for food allergy research. J Allergy Clin Immunol. 2021;147(3):992–1003. doi: 10.1016/j.jaci.2020.11.027
  45. Pongracic JA, Gagnon R, Sussman G, et al. Safety of epicutaneous immunotherapy in peanut-allergic children: REALISE randomized clinical trial results. J Allergy Clin Immunol. 2022;10(7):1864–1873.e10. doi: 10.1016/j.jaip.2021.11.017
  46. Fleischer DM, Shreffler WG, Campbell DE, et al. Long-term, open-label extension study of the efficacy and safety of epicutaneous immunotherapy for peanut allergy in children: PEOPLE 3-year results. J Allergy Clin Immunol. 2020;146(4):863–874. doi: 10.1016/j.jaci.2020.06.028
  47. Xiong L, Lin J, Luo Y, et al. The efficacy and safety of epicutaneous immunotherapy for allergic diseases: A systematic review and meta-analysis. Int Arch Allergy Immunol. 2020;181(3):170–182. doi: 10.1159/000504366
  48. Dunn GA, Fleischer DM, Campbell DE, et al. Improvements in quality of life in children following epicutaneous immunotherapy (EPIT) for peanut allergy in the PEPITES and PEOPLE studies. J Allergy Clin Immunol Pract. 2021;9(1):216–224. doi: 10.1016/j.jaip.2020.08.015

Copyright (c) 2023 Pharmarus Print Media

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies