Wheat oral immunotherapy was moderately successful but was associated with very frequent adverse events in children aged 6–18 years. (6th February 2018)

• Record Type: Journal Article
• Authors: Kulmala, Petri; Pelkonen, Anna S.; Kuitunen, Mikael; Paassilta, Marita; Remes, Sami; Schultz, Rüdiger; Dunder, Teija; Turunen, Sami; Mäkelä, Mika J.
• Is Part Of: Acta pædiatrica. Volume 107:Number 5(2018)
• Page Start: 861
• Page End: 870
• Publication Date: 2018-02-06
• Subjects: Children -- Desensitisation -- Food allergy -- Oral immunotherapy -- Wheat; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.14226
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: Aim: This study investigated oral immunotherapy (OIT) for children aged 6–18 years with wheat allergies. Methods: Well‐cooked wheat spaghetti was given to 100 children with wheat allergies every day for 17 weeks, increasing from 0.3 to 2000 mg of wheat protein, followed by three‐ and nine‐month maintenance phases. Blood samples were taken before therapy and at follow‐up visits. The study was carried out in 2009–2015 in four Finnish paediatric allergology units. Results: The children (67% male) had a mean age of 11.6 years (range 6.1–18.6), and 57 were using wheat daily 16 months after the initiation of therapy. Allergic symptoms occurred in 94/100 children: mild in 34, moderate in 36 and severe in 24. Specific immunoglobulin E (IgE) for ω‐5‐gliadin was significantly higher in patients who did not reach the target dose and were related to the intensity of reactions. Conclusion: The majority (57%) of children with wheat allergies could use wheat in their daily diet 16 months after the initiation of OIT, but 94/100 had adverse reactions and 60 were moderate or severe. Specific IgE to ω‐5‐gliadin may provide a biomarker for how much wheat can be tolerated and the intensity of the reactions to immunotherapy.