Alessandro Fiocchi and Robert A Wood presented this workshop. Egg allergy is the only food allergy that can present at birth, suggesting prenatal factors involved in sensitization.
There are limits of the 'prohibitionist approach' to food allergy care.
Supplemental probiotics don't substantially alter intestinal microbiota, which is why we haven't yet seen robust effects.
8 foods cause 90% of food allergies (click to enlarge the image). The likelihood of a negative oral food challenge is shown in relation to the respective values of skin prick test (SPT) and serum IgE (sIgE).
Potential approaches for therapy food allergy: Xolair, chinese herbs, oral immunotherapy, ingestion of extensively heated milk and egg, patch immunotherapy.
For oral immunotherapy (OIT), it's important whether the intervention is transient or long-lived.
There are two groups of milk and egg allergy patients based on severity. Mild patients can be exposed to heated milk or egg will helps treat food allergy. Dr Wood recommended all kids with milk or egg allergy to be considered for intro of heated egg/milk. Although Dr Wood has some cut-offs for IgEs (milk below 20, egg below 10), they will challenge kids with higher IgE (though success is low).
Can peanut proteins be engineered to block IgE binding sites that will allow for IT but be safer than normal peanut protein? Dr Wood developed a product called EMP-123 that worked best when delivered per rectum - Wood, Allergy, 2013.
Exercise is becoming a risk factor for OIT adverse effects, so no exercise within 2 hours of food OIT dosing is strongly recommended.
Dr Wood discussed the following study: Peanut SLIT in CoFAR - JACI 2013;131:119. There was some protection with slight increase by 68 weeks. But most benefit occurred within the first 44 weeks of therapy.
Dr Wood reviewed milk OIT vs SLIT - JACI 2012. SLIT less effective than OIT.
True tolerance with OIT is only accomplished in a minority of patients. Rates of adverse reactions to food IT are significant but likely acceptable.
Food allergy management in 4 steps (click to enlarge the image).
This is a Twitter summary from 2014 #ACAAI meeting. The post is a part of series. See the rest here: http://allergynotes.blogspot.com/search/label/ACAAI
The Twitter summary was made possible by @DrAnneEllis and @MatthewBowdish
Several allergists did a great job posting updates from the 2014 meeting of the #ACAAI. I used the website “All My Tweets” to review the tweets. For comparison, here are the tweets from previous #ACAAI meetings (scroll down the page for the past years): http://allergynotes.blogspot.com/search/label/ACAAI