Allergy drops have been and found effective for many people tested for egg allergies.
The New England Journal of Medicine published an article this week titled “Oral Immunotherapy for Treatment of Egg Allergy in Children“. The lead author was Dr.Wesley Burks, president of the Academy of Allergy, Asthma, and Immunology. The significant finding is that oral immunotherapy can desensitize a high proportion of children with egg allergy. In the long run, oral immunotherapy can induce long-standing protection against egg sensitivity so that children can continue to eat eggs after the treatment is stopped.
The excitement in this new field of oral immunotherapy is that previous studies have shown that this treatment is effective for peanut allergy, and now the same has been shown for egg allergy. Parents should be warned that this is not an overnight treatment success. Results take time.
- At 10 months of therapy, about 55% of the children treated with oral immunotherapy passed an egg food challenge.
- Even better– at 22 months 75% of the treated children were desensitized
- At 36 months all (100%) the children that had passed the challenge at 24 months passed that time.
lgG4, called the “blocking antibody” can be a marker of immune intolerance.
I’ll take those scores any day of the week! However, a few children did drop out of the study because of allergic reactions. Interestingly, one of the markers that seem to correlate with the children’s inability to pass the challenge is an elevated IgG4 level. This is the so-called “blocking antibody” which seems to be a marker of immune intolerance.
Some of the researchers of the article have been quoted in seminars as saying that this type of treatment is still under clinical investigation and is not ready for use in routine practice. That may hold some validity, but with parents clamoring for a safe and effective treatment for potentially life-threatening food allergies, a more rapid evaluation of how to bring this treatment into the mainstream is most needed.
My own experience with an egg-allergic patient was unforgettable. It was my first year in private practice and my patient said he wanted to be tested to see if he was still egg-allergic. He was diagnosed in his twenties with severe egg allergy after having an allergic shock (anaphylaxis) after eating a plate of eggs in a diner. He had to avoid restaurants because even a miniscule amount of egg in a pancake would cause a severe reaction. After 20 years, he came to see me. I initially did a blood test called the RAST on him and it was negative. Today, blood testing is much more accurate with the ImmunoCap and ISAC testing by Thermo Fisher. However, the patient couldn’t believe, nor could I that he was really ok to eat eggs. I decided to test further and performed a prick skin test to see his allergenicity. That was an unforgettable moment. The patient immediately broke out in hives and had trouble breathing, I had to give him 2 shots of adrenaline (epinephrine) to calm down the reaction. Needless to say, he stayed on his egg-free diet.
I believe we are at an exciting time in the treatment of food allergy. My message to children, adults, and parents: “Hang on– a cure is in sight.”
Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island