What Is Oral Immunotherapy
Oral immunotherapy desensitizes children & adults to their food allergens.
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Understanding Oral Immunotherapy and Food Desensitization
Oral immunotherapy (OIT) desensitizes children and adults to their food allergens.
By regularly consuming an allergen in increasing amounts, a patient’s immune system adapts to the substance that formerly would have caused a life-threatening anaphylactic reaction. Note that desensitized patients are still allergic. They consume their allergen regularly in order to maintain desensitization.
We say that this result is a “social cure.” Why? Because desensitization eliminates the many social confrontations that come with the need to question every bite of food, and thus brings an end to social exclusion due to food allergies.
We can also very accurately say that it’s an “emotional cure.” This is because it eliminates fear of food and along with that, the feeling of being different, and from being left out of interaction or simply being with peers.
What Is Oral Immunotherapy (OIT)?
Immunotherapy is not a new process. Desensitization through ingesting small amounts of a substance has been used for centuries. Oral immunotherapy is a more recent approach, but it has over a decade of research in clinical trials to back up its effectiveness. Allergic people consume an allergen, such as peanut protein, and gradually build up their tolerance. After around six months to a year – including regular appointments at our Atlanta-area food allergy treatment centers – it is possible to eat the allergy-causing food without experiencing a reaction.
How Does Oral Immunotherapy Work?
The process begins with a build-up day under careful observation. OIT can then continue at home, with daily doses of an allergen and regular allergist appointments. The dosage is raised over a period of months. Initially, the patient’s immune system might only be able to handle small levels of an allergen without reacting. However, as the dosage increases, the immune system adapts and becomes desensitized to the protein in the food.
OIT – From Reaction to Tolerance
As there is the risk of an allergic reaction, your allergist will carefully monitor your response to consuming the allergen. After all tests have been passed, you can continue the simple process of taking doses each day. Successful OIT should lead to the allergic food being integrated into your diet without fear of allergic reactions. But you will need to continue maintenance doses to ensure your immune system doesn’t lose tolerance.
Success Rate for Oral Immunotherapy Patients
OIT has provided a 60–80% success rate for peanut, egg and milk allergies in clinical trials. Success is measured by food challenges that assess tolerance levels. An allergist will give a patient the allergenic food at three times the amount of their daily dose. If they can consume this amount without negative side effects, they can move to a maintenance dose. If a reaction is experienced, the OIT will resume.
Main Food Allergies Treated With OIT
An allergy to peanuts is one of the most common food allergies. Young children frequently experience allergic reactions to peanuts, though it can impact people of all ages. Peanuts can be a difficult food to manage, as they are present as an ingredient in many dishes. Therefore, OIT is a valuable way to protect a person’s health. And while the introduction of the peanut pill, Palforzia, caused a great deal of interest, it actually uses peanut powder. In contrast, Dr. Chacko typically uses real peanuts, helping patients to reach a higher maintenance level.
Milk is another food that is difficult to avoid. Young children often experience milk allergies, and risk missing out on calcium and other valuable nutrients. OIT is used to treat milk allergies, particularly where individuals are at risk of a severe reaction. With cow’s milk often being the cause of the allergy, it’s important to ask your allergist about replacement milk products before you have completed the desensitization process.
It is believed that around 2% of all children are allergic to eggs. And while many of these kids will only experience mild symptoms like skin rashes, stomach aches and congestion, a small number can suffer anaphylaxis. Of course, eggs are a common ingredient in baked goods, pasta, salad dressings, ice cream and so many other foods. The advantage of going through the OIT process is being able to continue eating these food products without worrying about severe allergic reactions.
Why Is Oral Immunotherapy Treatment So Important?
OIT is important for many reasons, but the ability to manage your allergy is a crucial advantage over other treatments. Avoidance of popular food types is becoming increasingly difficult, with parents expected to comb through lists of ingredients for potential signs of concern. And while parents can be as dedicated as possible in the home, micromanaging a diet also includes food in restaurants and other locations. It’s obvious that the ability to closely monitor food becomes almost impossible when away from home.
To illustrate this, one study estimated that between 40%–100% of deaths from anaphylaxis involved food that had been prepared outside of the home. The result here is often an excessively restricted diet, one that also has downsides for nutrition, socializing and much more. With these issues in mind, OIT ensures allergy sufferers have fewer restrictions after they have completed the desensitization process.
How Safe Is Oral Immunotherapy Treatment?
With avoidance being the initial response to a food allergy, it can be difficult to immediately understand OIT. Consuming allergens and potentially risking an allergic reaction may seem like the last thing a parent would agree to. However, OIT is a safe process that places strict limits on how much of an allergen a patient is allowed to consume.
A mild allergic response during OIT is possible, and most likely to occur in the early stages. Most symptoms will not be particularly concerning, and your allergist will be available to monitor reactions during the buildup phase. Some studies have seen 10% dropout rates from trials as a result of adverse events. Again, these reactions are unlikely to be severe, and Dr. Chacko’s desensitization treatment prioritizes patient safety at all stages.
Common Questions About Oral Immunotherapy
Can I consume the food allergen in my daily diet after OIT?
After a successful treatment, you should be able to consume the food allergen while also taking occasional maintenance doses to keep tolerance levels high.
Is my child suitable for OIT?
OIT is suitable for children with food allergies. A consultation with Dr. Chacko can diagnose your child’s allergies and determine if OIT is the best approach.
Is OIT dangerous?
OIT is a safe process with numerous success stories. Again, there is the possibility of a reaction as you are consuming an allergen.
Don’t Delay Treating Your Food Allergy
Food allergies can have dangerous consequences if left untreated. Dr. Chacko is the leading food allergy doctor in the Atlanta area, helping adults and children desensitize themselves to food allergens with OIT. Visit one of our locations in Alpharetta, Atlanta, Canton, Cumming, Duluth and Johns Creek. Call the clinic for an appointment at 678-668-4688.