Oral Immunotherapy
Revolutionizing Food Allergy TreatmentThrough Immune System Reprogramming
Oral immunotherapy (OIT) is a treatment for food allergies that reprograms the immune system to tolerate allergenic foods.
By introducing incrementally increasing amounts of precisely measured food protein over an extended period, under the supervision of a board-certified allergist, OIT offers pediatric and adult patients the freedom to safely consume the foods that cause allergic reactions. The goal of OIT is to improve the safety and quality of life of those with allergies to peanuts, tree nuts, eggs, cow’s milk, soy, seeds, and other foods.
Allergy desensitization is not a new treatment. Pollen allergy desensitization was first introduced by Dr. Leonard Noone and Dr. John Freeman in 1911. Dr. Noone was the first to demonstrate that patients with hay fever who received repeated injections of pollen extract became desensitized to pollen. There are currently over 4,000 board-certified allergists in the United States who provide pollen allergy immunotherapy. The only difference between pollen desensitization and OIT is the method of introduction of the allergen. In the case of pollen desensitization, it is done via injection, whereas in the case of OIT, the method of desensitization is achieved orally.
A Safe and Effective Solution forFood Allergies Provided Under Expert Care
Our office offers an oral immunotherapy program for children and adults with food allergies that has given hundreds of people the freedom to ingest the foods that used to give them allergic reactions.
Our treatment provides a long-term solution for those with severe food allergies. It usually takes about 9 months for most patients to be able to consume the allergenic foods without reactions. OIT provides the opportunity for patients to safely incorporate food allergens into their diets following completion of the program, but it does so by increasing the threshold at which an allergic reaction occurs. Patients undergoing OIT are required to maintain a daily consumption of the allergenic food to maintain that state of desensitization, both during and after the completion of the program.
OIT can help improve quality of life by allowing patients to safely consume allergenic food and not worry about strict avoidance. Strict avoidance is not 100% effective. Nearly 25% of patients have had a near-fatal anaphylactic reaction at some point in their lives. OIT helps alleviate the risk of severe allergic reactions/anaphylaxis.
OIT must always be performed under the care of a highly skilled board-certified allergist with specialized training in OIT. OIT should never be performed at home, or by other physicians who lack the necessary specialized training.
The OIT Treatment Journey: A Step-by-Step Guide to Overcoming Food Allergies
The first step is to set up an initial consultation with Dr. Shilian.
This takes about an hour, during which the doctor will order labs and/or perform skin tests, and then determine if OIT is the right treatment (OIT treats food allergies that are IgE-mediated but will not treat food intolerances, celiac disease, or cell-mediated food allergies). A follow-up visit is scheduled within 2-3 weeks where the test results are discussed and all necessary paperwork is completed. After that, a full-day visit is scheduled where the patient will receive multiple doses of very small amounts of the allergen. The patient will return to the office weekly (or every other week) for dose increases followed by one hour of observation. Between each visit, the patient will take the daily dose at home. Once OIT is completed, the previously allergenic food can be freely included in the diet. The food must be eaten daily to maintain the state of desensitization.
Determining the Eligibility for Oral Immunotherapy:A Comprehensive Approach
We consider many factors to help our patients determine if OIT is the right choice for them.
These include the risk of reaction to accidental ingestion, difficulty in avoiding the allergen, and the psychological impact of food allergy on patients and their families. Food allergy affects 6% of children and 1% of adults. Severe food allergies can be devastating for patients and their loved ones. It may impact their ability to participate fully in school, sports, and family and social activities.
OIT is not for everyone. That is why we screen our patients very carefully. Over the past few years, many patients were referred to our office for OIT but upon further testing, we were able to determine that they had outgrown the allergy. We have saved hundreds of families from undergoing treatment because it was simply not necessary. It is also important to note that OIT is contraindicated in patients with inflammatory diseases of the gastrointestinal tract such as celiac disease, cell-mediated food allergy, eosinophilic esophagitis, and/or food intolerances.
Key ConsiderationsDetermining if Oral Immunotherapy is the Right Solution for You
- Severe Food Allergies: You or your child has a severe food allergy (e.g., peanuts, tree nuts, eggs, milk, soy) that impacts daily life.
- Difficulty Avoiding Allergens: Avoiding allergens is challenging or risky due to the environment, activities, or food exposure.
- Risk of Severe Reactions: Accidental ingestion has led to severe allergic reactions (like anaphylaxis) or there is a significant risk of this happening.
- Psychological Impact: Food allergies are affecting emotional well-being, mental health, or social activities, including limitations at school, sports, or family gatherings.
- Desire to Safely Reintroduce Allergens: You are interested in reintroducing allergenic foods into your diet to reduce reliance on strict avoidance.
- Age Group: OIT can be used for both children and adults with IgE-mediated food allergies (not for food intolerances or celiac disease).
- Expert Supervision Required: You should only consider OIT if it’s under the supervision of a board-certified allergist with specialized training in OIT.
- Commitment to Daily Maintenance: Willingness to commit to the daily consumption of allergenic foods to maintain desensitization even after completing the program.
- Not for All Patients: If you have gastrointestinal conditions like celiac disease or eosinophilic esophagitis, OIT may not be a suitable option.
Navigating the Steps to Begin Oral Immunotherapy for Food Allergies
FAQs for Oral Immunotherapy Treatment
What is Oral Immunotherapy (OIT)?
Oral Immunotherapy (OIT) is a treatment designed to help individuals with food allergies build tolerance to allergenic foods. It involves the gradual introduction of small, controlled amounts of food protein over time, which helps reprogram the immune system to safely tolerate the food that was previously causing an allergic reaction.
How long does the OIT process take?
The OIT treatment typically takes about 9 months for most patients. During this period, patients will gradually increase their tolerance to the allergenic food under the supervision of a board-certified allergist. After completing the program, the food can be safely included in the diet, though daily consumption is required to maintain desensitization.
Is OIT safe?
Yes, OIT is safe when performed under the supervision of a highly skilled, board-certified allergist with specialized training in OIT. It should never be done at home or without professional guidance to ensure proper management and safety during the treatment process.
What foods can be treated with OIT?
OIT can be used to treat allergies to a variety of foods, including peanuts, tree nuts, eggs, cow’s milk, soy, seeds, and more. However, it is only suitable for IgE-mediated food allergies and will not treat food intolerances or conditions like celiac disease.
How do I know if OIT is right for me?
OIT is right for individuals who have severe food allergies that impact daily life, find it difficult to avoid allergens, or have experienced anaphylaxis. If you are considering this treatment, a thorough evaluation by a skilled allergist will help determine if it’s the best option for your specific condition.
What is the long-term commitment required after completing OIT?
After completing the OIT program, patients must continue to consume the allergenic food daily to maintain their desensitization. Regularly consuming the food ensures the immune system remains tolerant and minimizes the risk of a future allergic reaction.
How is the treatment administered?
The treatment begins with an initial consultation where the allergist may conduct lab tests or skin tests. If OIT is appropriate, patients will receive small doses of the allergen in a controlled office setting. Dose increases occur weekly or bi-weekly, followed by one hour of observation. Between visits, patients will take their daily dose at home.
What happens if I miss a dose?
It is crucial to take the prescribed daily dose to maintain desensitization. If a dose is missed, consult your allergist for guidance on how to proceed. It is important to stick to the schedule to ensure the effectiveness of the treatment.
Who is a candidate for OIT?
OIT is suitable for individuals with severe food allergies (such as peanuts, tree nuts, eggs, or milk) that significantly affect their daily lives. It is ideal for those who have difficulty avoiding allergens or are at risk of severe allergic reactions, like anaphylaxis. OIT is not recommended for patients with food intolerances, celiac disease, or certain gastrointestinal conditions such as eosinophilic esophagitis.
Can OIT be performed at home?
No, OIT must always be performed under the supervision of a qualified allergist in a medical setting. The allergist will monitor the patient closely to ensure safety, especially during dose adjustments and increases.
Are there any risks associated with OIT?
As with any medical treatment, there are potential risks. The gradual introduction of the allergen can lead to mild reactions, and there is a small risk of more severe reactions. This is why OIT should always be conducted under the supervision of an allergist who is trained to manage these situations.
Is OIT suitable for children?
Yes, OIT can be used for both children and adults with IgE-mediated food allergies. It is especially beneficial for children who struggle with severe food allergies and find it difficult to avoid certain foods in everyday situations.
How do I get started with OIT?
To begin OIT, schedule an initial consultation with a board-certified allergist. The doctor will assess your allergy history, conduct tests, and determine if OIT is appropriate for your condition. Call the office today to book your consultation and start your treatment journey.
An exceptional allergy, asthma, and immunology practice in Encino, California, led by experienced allergist Dr. Ryan Shilian.