Oral immunotherapy (OIT) to milk and egg is yet an experimental treatment, performed in food allergy specialized centers, as OIT carries significant risks for allergic adverse reactions. Different OIT protocols can be used, however desensitization is possible in most patients, and this ability to induce longer-term tolerance is controversial. As milk and egg allergy usually resolve in school-aged children, the age of intervention with OIT is still a matter of debate.

Current guidelines suggest offering OIT to selected children, with persistent severe IgE- mediated hen’s egg or cow’s milk allergy, at age 4. However, there is some evidence that the achievement of sustained unresponsiveness can be higher when OIT begins before this age, and with fewer systemic adverse allergic reactions. On the other hand, there is no recommendation for or against offering OIT to adolescents and adults with IgE-mediated, cow’s milk or hen’s egg allergy. However, OIT may be useful in selected cases if potential benefits outweigh the risks.

This Research Topic aims to explore the results of different OIT protocols to milk and egg performed in food allergic patients in preschool ages, in adolescence, and in adults. As there are no recommendations for these ages, a comprehensive analysis of the results of these studies, could potentially lead to advances in the development of recommendations to intervention in a broader scope of age. It will focus on evaluating potential predictive factors to achieve sustained unresponsiveness/desensitization, with fewer systemic allergic reactions conducting to higher rates of success. Original manuscripts are desired, but review articles can also be contemplated.

We are specifically looking to expand the following themes:
• Sustained unresponsiveness to milk and eggs after oral immunotherapy.
• Oral immunotherapy to milk and eggs in preschool-age children.
• Oral immunotherapy to milk and eggs in adolescents and adults.
• Identification and evaluation of potential predictive factors associated with tolerance induction.
• Identification and evaluation of potential predictive factors associated with the risk and/or severity of systemic adverse allergic reactions, during OIT to milk and egg.

Disclaimer: Topic Editor Alexandra Santos has received research grants from Food Allergy Research and Education (FARE) and Immune Tolerance Network/NIAID, and is a Speaker and/or Consultant on an Advisory Board for Novartis, ThermoFisher Scientific, Bühlmann, Nutricia, Nestle, InfoMed, Allergy Therapeutics, Stallergenes and IgGenix. The other Topic Editors declare no competing interests with regard to the Research Topic subject.

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Frontiers in Allergy

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