Specific oral tolerance induction

in food allergy in children:

efficacy and clinical patterns of
reaction

Tira Aisah P
ABOUT Immunological Tolerance

inability of the immune system to respond

(unresponsiveness) to an antigen due to
previous induction of the same antigen

Lymphocyte cells that encounter antigens can

become active and produce an immune
response, or they can become inactive or
eliminated and result in tolerance.

antigen that causes tolerance is called

tolerogen (tolerogenic antigens). Tolerance to
antigens that the body produces (self-antigen)
is known as self-tolerance.
 ABOUT ORAL TOLERANCE

By learning how to induce tolerance in

lymphocytes that are specific to specific
antigens we can use this knowledge to
why immunological prevent or control unwanted immune
reactions.
tolerance needs to be
studied ?
INTRODUCTION

prevalence food the only accepted but for cow's milk patients have a high risk of
allergy ↑ : > 6% in therapy is a strict or hen's egg is severe allergic reactions in
children elimination diet. difficult to avoid the case of accidental
ingestion

(SOTI) achieved by oral SOTI anaphylactic

exposure to increasing Specific oral tolerance induction reactions
doses of the specific food
allergen.
improving both quality of
life and safety in the
event of accidental
ingestion of the o ff
ending food
METHODS

45 Children after 21 months to evaluate

( 25 : SOTI group + 20 : persistence of induced oral
control group) tolerance.

Study population Re-evaluation

Study Protocol
IP (Induction Phase) for both CM and HE was 67 days.

Base : 0,02 mg CM protein/ 0,006 mg HE protein

Maks : 8250 mg CM protein / 2800 mg HE protein

 RESULT

}
14 children ompleted the IP in a
period between
70 days and 12 months

2 children had an median duration of the IP

N = 25 children
extremely slow IP (28 and 46 is 7 month
months)

9 children the induction was not

completed
RESULT
RESULT
DISCUSSION

01 Patricia (2003)
83% of the children in the This Study
SOTI group became tolerant
after 18 months whereas all
children under elimination die 03 permanent tolerance in the

02
SOTI group (36%) and in the
eliminaton group (35%)
Meglio (2004)
SOTI has shown promising
results with efficacy rates
between 75% and 86%.
DISCUSSION

01 Previous Study
side-effects are reported in This Study
50–60% of cases on SOTI
02 all children in the SOTI group
experienced side-effects to
some extent.
In contrast, one severe
allergic reaction occurred in
the control group after
accidental ingestion of the
food.
 DISCUSSION

This • development of tolerance was associated

with a significant reduction in sIgE, so
the quality of life is increased and the
risk for severe allergic reactions in case
of accidental ingestion is decreased.

study
• 1.5–2 years, “real” desensitization is
reached as shown by the disappearance
of IgE antibodies
 CONCLUTION
• SOTI seems a valid treatment option for
patients with persistent food allergy.

Advantages of SOTI are the increased

threshold dose for allergic reactions and the
substantially reduced risk of severe allergic
reactions after inadvertentingestion of the
allergen
THANKS
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