Allergen-specific immunotherapy for food allergies in childhood. Current options and future perspectives

During recent years increasing research has been conducted on casual treatment options for food allergy, with focus on oral immunotherapy (OIT) for hen's egg, cow's milk and peanut allergy. Several studies could show that OIT leads to desensitization or an increase of threshold. However, severe adverse events during this treatment are not uncommon. Whether OIT leads to a sustained, 'robust' development of tolerance in patients has not yet been thoroughly investigated. Besides OIT, some studies on sublingual (SLIT) and epicutaneous immunotherapy (EPIT) were performed, aiming to improve the safety profile. Furthermore, there are some pilot studies investigating a combined treatment of SLIT and OIT or a combined use of anti-IgE treatment or probiotic supplementation with OIT. Further placebo-controlled trials with larger sample size are needed in order to develop standardized protocols before immunotherapy may be used as a therapeutic option for food allergy outside of clinical trials.