Oral Immunotherapy May Offer New Treatment for Egg Allergy
In the July 2012 issue of the New England Journal of Medicine, two ACHRI researchers are among the authors of an article with results demonstrating that oral doses of egg white powder given daily and increasing in amounts may allow children and adolescents with egg allergy to eat egg-containing foods without an allergic reaction. Dr. Stacie Jones and Dr. Amy Scurlock studied pediatric patients in the largest food allergy study for egg allergy. ACHRI is among a network of five sites in the NIH-funded Consortium of Food Allergy Research (CoFAR), which conducted the study co-led by Dr. Jones and Dr. Wesley Burks of University of North Carolina and former ACHRI President. Dr. Jones and Dr. Burks were co-lead authors of the publication.
In the study, egg allergic children received daily doses of egg white powder in small increasing doses or a placebo. After 10 months and 22 month of escalating doses, the children were given food challenges under the guidance of the research team. At 22 months, the researchers found that 75% of the children receiving the egg white powder were desensitized. These children were then asked to avoid egg consumption for 4 to 6 weeks at which time they received a third food challenge of egg white powder and a cooked egg to test for sustained unresponsiveness. At this third food challenge, now 2 years into the study, 28% passed. The children passing this test were then placed on a diet allowing egg consumption without restriction and were evaluated for continued unresponsiveness to egg at 30 and 36 months. The results show that all children passing the challenge at 2 years also passed the 30 and 36 month challenges.
Study participants from ACH were allergy patients seen by Dr. Jones and Dr. Scurlock. Among them was Caroline who started in the study at age seven and had egg among her food allergies. Caroline and her family were committed to avoiding eggs to manage her allergy. They discussed the study with Research Coordinator Anne Hiegel and Dr. Jones. Caroline's mother Marla thought the study may help her daughter's quality of life and Caroline was at an age to communicate what was occurring with her regarding her allergy. The family was confident in the safe environment and outstanding quality of care at ACH so Caroline enrolled in the study.
Caroline received the egg white powder doses, which she sprinkled on strawberry applesauce to eat, and passed the food challenges throughout the study. She now eats eggs without an allergic reaction. Though not all children participating in the study showed the full clinical response of being able to consume eggs freely, but most participants had the benefit of added protection from an accidental ingestion. The researchers plan further studies to examine dosing and timing of the oral immunotherapy to improve its effectiveness as well as the safety of the therapy. This fall, they will begin a study comparing the egg powder oral immunotherapy to a therapy with baked egg. In addition, the team is also examining other food allergy therapies including an oral immunotherapy studies for walnut allergy and for peanut allergy and a new skin patch therapy to treat peanut allergy.