Immunotherapy (oral and sublingual) for food allergy to fruits (Review)

ABSTRACT: BackgroundFood allergy is an abnormal immunological response following exposure (usually ingestion) to a food. Elimination of the allergen is theprinciple treatment for food allergy, including allergy to fruit. Accidental ingestion of allergenic foods can result in severe anaphylacticreact...

Full description

Autores:
Yepes Nuñez, Juan José
Zhang, Yuan
Roqué i Figuls, Marta
Bartra Tomas, Joan
Reyes, Juan Manuel
Pineda de la Losa, Fernando
Enrique, Ernesto
Tipo de recurso:
Review article
Fecha de publicación:
2015
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/26332
Acceso en línea:
http://hdl.handle.net/10495/26332
Palabra clave:
Adulto
Adult
Frutas
Fruit
Pyrus
Hipersensibilidad a los Alimentos
Food Hypersensitivity
Desensibilización Inmunológica
Desensitization, Immunologic
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc-sa/2.5/co/
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network_acronym_str UDEA2
network_name_str Repositorio UdeA
repository_id_str
dc.title.spa.fl_str_mv Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
title Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
spellingShingle Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
Adulto
Adult
Frutas
Fruit
Pyrus
Hipersensibilidad a los Alimentos
Food Hypersensitivity
Desensibilización Inmunológica
Desensitization, Immunologic
title_short Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
title_full Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
title_fullStr Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
title_full_unstemmed Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
title_sort Immunotherapy (oral and sublingual) for food allergy to fruits (Review)
dc.creator.fl_str_mv Yepes Nuñez, Juan José
Zhang, Yuan
Roqué i Figuls, Marta
Bartra Tomas, Joan
Reyes, Juan Manuel
Pineda de la Losa, Fernando
Enrique, Ernesto
dc.contributor.author.none.fl_str_mv Yepes Nuñez, Juan José
Zhang, Yuan
Roqué i Figuls, Marta
Bartra Tomas, Joan
Reyes, Juan Manuel
Pineda de la Losa, Fernando
Enrique, Ernesto
dc.subject.decs.none.fl_str_mv Adulto
Adult
Frutas
Fruit
Pyrus
Hipersensibilidad a los Alimentos
Food Hypersensitivity
Desensibilización Inmunológica
Desensitization, Immunologic
topic Adulto
Adult
Frutas
Fruit
Pyrus
Hipersensibilidad a los Alimentos
Food Hypersensitivity
Desensibilización Inmunológica
Desensitization, Immunologic
description ABSTRACT: BackgroundFood allergy is an abnormal immunological response following exposure (usually ingestion) to a food. Elimination of the allergen is theprinciple treatment for food allergy, including allergy to fruit. Accidental ingestion of allergenic foods can result in severe anaphylacticreactions. Allergen-specific immunotherapy (SIT) is a specific treatment, when the avoidance of allergenic foods is problematic. Recently,studies have been conducted on different types of immunotherapy for the treatment of food allergy, including oral (OIT) and sublingualimmunotherapy (SLIT).ObjectivesTo determine the efficacy and safety of oral and sublingual immunotherapy in children and adults with food allergy to fruits, whencompared with placebo or an elimination strategy.Search methodsThe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and AMED were searched for published resultsalong with trial registries and the Journal of Negative Results in BioMedicine for grey literature. The date of the most recent search wasJuly 2015.Selection criteriaRandomised controlled trials (RCTs) comparing OIT or SLIT with placebo or an elimination diet were included. Participants were childrenor adults diagnosed with food allergy who presented immediate fruit reactions.Data collection and analysisWe used standard methodological procedures expected by the Cochrane Collaboration. We assessed treatment effect through risk ratios(RRs) for dichotomous outcomes. Main resultsWe identified two RCTs (N=89) eligible for inclusion. These RCTs addressed oral or sublingual immunotherapy, both in adults, with an allergyto apple or peach respectively. Both studies enrolled a small number of participants and used different methods to provide these differingtypes of immunotherapy. Both studies were judged to be at high risk of bias in at least one domain. Overall, the quality of evidence wasjudged to be very low due to the small number of studies and participants and possible bias. The studies were clinically heterogeneous andhence we did not pool the results. A study comparing SLIT with placebo for allergy to peach did not detect a significant difference betweenthe number of patients desensitised at six months following a double-blind placebo-controlled food challenge (RR 1.16, 95% confidenceinterval (CI) 0.49 to 2.74). The second study, comparing OIT versus no treatment for apple allergy, found an effect on desensitisation infavour of the intervention using an oral provocation test at eight months, but results were imprecise (RR 17.50, 95% CI 1.13 to 270.19).Neither study reported data on evidence of immunologic tolerance. In both studies, the incidence of mild and moderate adverse eventswas higher in the intervention groups than in the controls. In the study comparing SLIT with placebo, patients in the intervention groupexperienced significantly more local adverse reactions than participants in the control group (RR 3.21, 95% CI 1.51 to 6.82), though therewas not a significant difference in the number of participants experiencing systemic adverse reactions (RR 0.81, 95% CI 0.22 to 3.02). Inthe study of OIT, two of the 25 participants in the intervention group reported relevant side effects, whereas no participants in the controlgroup reported relevant side effects.
publishDate 2015
dc.date.issued.none.fl_str_mv 2015
dc.date.accessioned.none.fl_str_mv 2022-02-28T21:33:12Z
dc.date.available.none.fl_str_mv 2022-02-28T21:33:12Z
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dc.identifier.citation.spa.fl_str_mv Yepes-Nuñez JJ, Zhang Y, Roqué i Figuls M, Bartra Tomas J, Reyes Sanchez JM, Pineda de la Losa F, Enrique E. Immunotherapy (oral and sublingual) for food allergy to fruits. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD010522. DOI: 10.1002/14651858.CD010522.pub2.
dc.identifier.issn.none.fl_str_mv 1361-6137
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10495/26332
dc.identifier.doi.none.fl_str_mv 10.1002/14651858.CD010522.pub2.
dc.identifier.eissn.none.fl_str_mv 1469-493X
identifier_str_mv Yepes-Nuñez JJ, Zhang Y, Roqué i Figuls M, Bartra Tomas J, Reyes Sanchez JM, Pineda de la Losa F, Enrique E. Immunotherapy (oral and sublingual) for food allergy to fruits. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD010522. DOI: 10.1002/14651858.CD010522.pub2.
1361-6137
10.1002/14651858.CD010522.pub2.
1469-493X
url http://hdl.handle.net/10495/26332
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournalabbrev.spa.fl_str_mv Cochrane Database Syst Rev
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dc.publisher.spa.fl_str_mv Wiley
dc.publisher.group.spa.fl_str_mv Grupo de Alergología Clínica y Experimental (GACE)
dc.publisher.place.spa.fl_str_mv Oxford, Reino Unido
institution Universidad de Antioquia
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spelling Yepes Nuñez, Juan JoséZhang, YuanRoqué i Figuls, MartaBartra Tomas, JoanReyes, Juan ManuelPineda de la Losa, FernandoEnrique, Ernesto2022-02-28T21:33:12Z2022-02-28T21:33:12Z2015Yepes-Nuñez JJ, Zhang Y, Roqué i Figuls M, Bartra Tomas J, Reyes Sanchez JM, Pineda de la Losa F, Enrique E. Immunotherapy (oral and sublingual) for food allergy to fruits. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD010522. DOI: 10.1002/14651858.CD010522.pub2.1361-6137http://hdl.handle.net/10495/2633210.1002/14651858.CD010522.pub2.1469-493XABSTRACT: BackgroundFood allergy is an abnormal immunological response following exposure (usually ingestion) to a food. Elimination of the allergen is theprinciple treatment for food allergy, including allergy to fruit. Accidental ingestion of allergenic foods can result in severe anaphylacticreactions. Allergen-specific immunotherapy (SIT) is a specific treatment, when the avoidance of allergenic foods is problematic. Recently,studies have been conducted on different types of immunotherapy for the treatment of food allergy, including oral (OIT) and sublingualimmunotherapy (SLIT).ObjectivesTo determine the efficacy and safety of oral and sublingual immunotherapy in children and adults with food allergy to fruits, whencompared with placebo or an elimination strategy.Search methodsThe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and AMED were searched for published resultsalong with trial registries and the Journal of Negative Results in BioMedicine for grey literature. The date of the most recent search wasJuly 2015.Selection criteriaRandomised controlled trials (RCTs) comparing OIT or SLIT with placebo or an elimination diet were included. Participants were childrenor adults diagnosed with food allergy who presented immediate fruit reactions.Data collection and analysisWe used standard methodological procedures expected by the Cochrane Collaboration. We assessed treatment effect through risk ratios(RRs) for dichotomous outcomes. Main resultsWe identified two RCTs (N=89) eligible for inclusion. These RCTs addressed oral or sublingual immunotherapy, both in adults, with an allergyto apple or peach respectively. Both studies enrolled a small number of participants and used different methods to provide these differingtypes of immunotherapy. Both studies were judged to be at high risk of bias in at least one domain. Overall, the quality of evidence wasjudged to be very low due to the small number of studies and participants and possible bias. The studies were clinically heterogeneous andhence we did not pool the results. A study comparing SLIT with placebo for allergy to peach did not detect a significant difference betweenthe number of patients desensitised at six months following a double-blind placebo-controlled food challenge (RR 1.16, 95% confidenceinterval (CI) 0.49 to 2.74). The second study, comparing OIT versus no treatment for apple allergy, found an effect on desensitisation infavour of the intervention using an oral provocation test at eight months, but results were imprecise (RR 17.50, 95% CI 1.13 to 270.19).Neither study reported data on evidence of immunologic tolerance. In both studies, the incidence of mild and moderate adverse eventswas higher in the intervention groups than in the controls. In the study comparing SLIT with placebo, patients in the intervention groupexperienced significantly more local adverse reactions than participants in the control group (RR 3.21, 95% CI 1.51 to 6.82), though therewas not a significant difference in the number of participants experiencing systemic adverse reactions (RR 0.81, 95% CI 0.22 to 3.02). Inthe study of OIT, two of the 25 participants in the intervention group reported relevant side effects, whereas no participants in the controlgroup reported relevant side effects.COL005956730application/pdfengWileyGrupo de Alergología Clínica y Experimental (GACE)Oxford, Reino Unidoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_dcae04bchttp://purl.org/coar/resource_type/c_2df8fbb1https://purl.org/redcol/resource_type/ARTREVArtículo de revisiónhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc-sa/2.5/co/http://purl.org/coar/access_right/c_abf2https://creativecommons.org/licenses/by-nc-sa/4.0/Immunotherapy (oral and sublingual) for food allergy to fruits (Review)AdultoAdultFrutasFruitPyrusHipersensibilidad a los AlimentosFood HypersensitivityDesensibilización InmunológicaDesensitization, ImmunologicCochrane Database Syst RevCochrane Database of Systematic Reviews13011ORIGINALJuanYepes_2015_ImmunotherapyAllergyFruits.pdfJuanYepes_2015_ImmunotherapyAllergyFruits.pdfArtículo de revisiónapplication/pdf400148http://bibliotecadigital.udea.edu.co/bitstream/10495/26332/1/JuanYepes_2015_ImmunotherapyAllergyFruits.pdf2811be120b7cdfda53f2541f48342503MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81051http://bibliotecadigital.udea.edu.co/bitstream/10495/26332/2/license_rdfe2060682c9c70d4d30c83c51448f4eedMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://bibliotecadigital.udea.edu.co/bitstream/10495/26332/3/license.txt8a4605be74aa9ea9d79846c1fba20a33MD5310495/26332oai:bibliotecadigital.udea.edu.co:10495/263322022-02-28 16:33:12.821Repositorio Institucional Universidad de Antioquiaandres.perez@udea.edu.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