Titre :

Oral Immunotherapy for Hazelnut Allergy: A Single-Center Retrospective Study on 100 Patients

Auteur(s) :

Moraly, Tomas [Auteur correspondant]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]
Pelletier de Chambure, Diane [Auteur]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Verdun, Stephane [Auteur]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]
Preda, Christian [Auteur]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]
Seynave, Maxime [Auteur]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]
Vilain, Anne Christine [Auteur]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]
Chenivesse, Cecile [Auteur]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Delebarre-Sauvage, Christine [Auteur]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]

Titre de la revue :

Journal of Allergy and Clinical Immunology: In Practice

Pagination :

704 - 709.e4

Éditeur :

Elsevier / American Academy of Allergy, Asthma & Immunology / American Academy of Allergy, Asthma and Immunology

Date de publication :

2020-02-29

ISSN :

2213-2198

Mot(s)-clé(s) en anglais :

Desensitization
Food allergy
Hazelnut
Oral immunotherapy
Tolerance

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background: Oral immunotherapy (OIT) protects patients with IgE-mediated food allergies from food-induced allergic reactions due to accidental exposure and may improve their quality of life. This approach has never been ...
Lire la suite >Background: Oral immunotherapy (OIT) protects patients with IgE-mediated food allergies from food-induced allergic reactions due to accidental exposure and may improve their quality of life. This approach has never been evaluated for hazelnut, a major cause of food allergy in Europe.Objective: To determine the proportion of hazelnut-desensitized patients after 6 months of OIT and to identify predictors of successful desensitization.Methods: In a retrospective single-center study, we included patients younger than 18 years who underwent at least 6 months of hazelnut OIT for IgE-mediated allergy, defined by history of hypersensitivity reaction after hazelnut ingestion, positive hazelnut skin prick test result or specific IgE, and positive double-blind, placebo-controlled food challenge. Patients able to tolerate 1635 mg of hazelnut protein (∼8 hazelnuts) were considered to be hazelnut desensitized. We determined the proportion of desensitized patients after 6 months of OIT, searched for associations between baseline variables and successful desensitization, and estimated the frequency and severity of OIT-related adverse reactions.Results: One hundred patients were included (64% males; median age, 5 years). History of severe reactions was noted in 7% of cases. At 6 months, the proportion of desensitized patients was 34% (95% CI, 25-44). The median eliciting dose (defined as the amount of hazelnut protein provoking a hypersensitivity reaction during the double-blind, placebo-controlled food challenge) increased from 106 mg (interquartile range, 51-249) at baseline to 523 mg (interquartile range, 190-1635) after 6 months of OIT (P < .0001). With longer therapy, the proportion of desensitized patients increased. Using multivariate analysis, successful desensitization was associated with older age (odds ratio [OR], 1.5; 95% CI, 1.2-2.2), smaller hazelnut skin prick test wheal diameter (OR, 0.61; 95% CI, 0.4-0.8), lower hazelnut specific IgE level (OR, 0.86; 95% CI, 0.72-0.98), and absence of cashew allergy (OR, 0.42; 95% CI, 0.12-0.64). Adverse reactions occurred in 30% of patients; none were severe.Conclusions: In a cohort of 100 patients aged 3 to 9 years, our results show for the first time that hazelnut OIT is associated with hazelnut desensitization and may be safe in most patients undergoing this therapy.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Collections :

• Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 9017

Source :

Harvested from HAL