Continuing Medical Education

Novel therapies in the management of food allergy: Oral immunotherapy and anti-IgE

C L Gray, E Goddard, S Karabus, M Kriel, A C Lang, A I Manjra, S M Risenga, A J Terblanche, D A van der Spuy, M E Levin

Abstract


The process of oral immunotherapy (OIT) consists of a series of dose escalations with the immediate goal of inducing desensitisation and ultimately achieving a state of tolerance.

Owing to the limitations of OIT, including side-effects and lack of proven efficacy in long-term tolerance induction, it is not yet recommended in routine clinical practice and should be restricted to the research setting. 

Studies using anti-immunoglobulin E (IgE) antibody in food allergy management are limited, but show promising results. The possible applications are for increasing the sensitivity threshold to certain foods such as peanut, and also for use in combination with OIT to enhance safety and rapidity of the OIT process; however, anti-IgE is not yet licensed for use in food allergy.

 

Authors' affiliations

C L Gray, Private Practice, Vincent Pallotti Hospital, Pinelands, Cape Town, South Africa

E Goddard, Division of Paediatric Gastroenterology, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

S Karabus, Private Practice, Christiaan Barnard Memorial Hospital, Cape Town, and Division of Allergy, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

M Kriel, Private Practice, Alberton, Johannesburg, South Africa

A C Lang, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

A I Manjra, Private Practice, Westville, Durban, South Africa

S M Risenga, Department of Pulmonology and Allergy, Faculty of Health Sciences, Polokwane Campus, University of Limpopo, Polokwane, South Africa

A J Terblanche, Department of Paediatrics, Faculty of Health Sciences, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa

D A van der Spuy, Private Practice, Cape Town, South Africa

M E Levin, Division of Allergy, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

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Keywords

Food allergy; Oral immunotherapy; Anti-IgE

Cite this article

South African Medical Journal 2015;105(1):74. DOI:10.7196/SAMJ.9105

Article History

Date submitted: 2014-10-29
Date published: 2014-11-21

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