The potential of early-life oral immunotherapy as a disease-modifying treatment for food allergy

Abstract

Food allergies are common in young children and have a significant impact on daily life. Moreover, most food allergies persist throughout a person’s life. Current treatment focuses on preventing allergic reactions by strictly avoiding the food in question. There is an urgent need for a treatment that can influence the course of the disease. This thesis investigated the potential of oral immunotherapy at a young age to influence the course of food allergy. In this treatment, children eat a daily small amount of the food to which they are allergic. The aim is to teach the immune system that the food is safe. The first years of life may be particularly suitable for this treatment, as the immune system is still developing and a newly developed food allergy may not yet have been fully established. In the ORKA study, 124 children aged between 9 and 24 months with one or more food allergies were treated with oral immunotherapy. The treatment was safe and feasible, and parents generally found it manageable, although it required considerable daily effort. After one year of treatment, 85% of the completed treatment courses were successful: the food in question was tolerated. Notably, in nearly 93% of the treated allergies that were reassessed years later, tolerance had been maintained. These findings suggest that oral immunotherapy at a young age may influence the natural course of a food allergy. This changes the perspective on food allergy: from a chronic to a treatable condition. Further research is needed to determine what role this treatment should have in future clinical practice.