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Tolerance Induction By Oral Immunotherapy in Patients with Cow's Milk Allergy
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Mohsen Ebrahimi, MD, Masoud Movahedi, Mohammad Gharagozlou, MD, Majid Jafari, MD, Fatemeh Kiaee, Reza Farid, MD FAAAAI
Rationale: Our aim in this study was to evaluate the efficacy of oral immunotherapy in desensitization and tolerance induction in patients with cow's milk allergy.

Methods: This clinical trial was conducted in patients older than three years. Fourteen children with a history of cow's milk allergy, confirmed through a double-blind placebo controlled food challenge test, specific IgE measurement, and skin prick test underwent oral immunotherapy for cow's milk over three phases: rush, build-up, and maintenance. One year follow-up by daily administration of 200-250 ml cow's milk were performed in patient’s who has positive response to oral immunotherapy. To assess tolerance, their consumption stopped for one month and open food challenge test was performed.

Results: In this study 14 patients (10 M and 4 F) were evaluated, of whom, 13 successfully completed immunotherapy course, and were desensitized. According to open food challenge test results, six patients tolerated cow's milk. A significant relationship was observed between duration of build-up period and severity of reaction symptoms and possible tolerance induction by the end of the study. Although prick test results and specific serum IgE levels against cow's milk and casein proteins were significantly reduced in the course of oral immunotherapy, no correlation was observed between amount of these parameters and possible tolerance induction in allergic patients.

Conclusions: Desensitization by oral immunotherapy was more effective than tolerance induction; however tolerance induction has better response in patients with mild and moderate allergic reaction in build-up phase.