Sampson, Hugh

Clinical and Translational Allergy

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Hugh Sampson

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Immunotherapy of food allergy: what is effective?

INVITED SPEAKER PRESENTATION Open Access
Immunotherapy of food allergy: what is effective?
Hugh Sampson
From Food Allergy and Anaphylaxis Meeting 2011
Venice, Italy. 17-19 February 2011
Food-induced anaphylaxis is the single leading cause of
anaphylaxis seen in emergency departments. Conse-
quently, a number of therapeutic strategies to treat food
allergies are being pursued. Two non-allergen-specific
therapies have been investigated in man: monoclonal
anti-human IgE antibodies and a Chinese herbal formu-
lation, FAHF-2. A trial with HU-901 anti-IgE was
shown to raise the threshold of reactivity significantly to
peanut in a study of peanut-allergic patients. FAHF-2,
which was found highly effective in blocking anaphylaxis
in a murine model of peanut allergy, was found safe in a
phase I safety trial and is now being evaluated in a
phase II efficacy trial. Other non-specific approaches
showing promise in preclinical studies include the
administration of Trichuris suis, Lactococcus lactis
transfected with IL-10 or with IL-12 and food b-lacto-
globulin, and a Toll-like receptor 9 agonist. A number
of allergen-specific therapies are also being investigated
in clinical trials: oral immunotherapy (OIT), sublingual
immunotherapy (SLIT), epicutaneous immunotherapy
(EPIT), modified recombinant peanut proteins within
heat-killed E coli (EMP-123), and administration of
baked (heat-denatured) foods. OIT appears to effectively
“desensitize” the majority of patients treated, although
adverse reactions remain problematic and whether “tol-
erance” can be induced remains to be determined. SLIT
appears promising in initial trials with fewer adverse
reactions, but whether tolerance can be established is
not clear. EPIT and EMP-123 are in early clinical trials,
although a small uncontrolled trial of milk-EPIT sug-
gested a beneficial effect with minimal adverse symp-
toms. In one clinical trial, administering baked milk-
containing products to children who tolerated this form
of the food (~80% of milk-allergic children) was found
to lead to “tolerance” in ~60% of the children over a
2 - 3 year period. Other approaches that have shown
promise in preclinical studies include peptide (T-cell
epitope) immunotherapy, plasmid immunotherapy,
immunostimulatory sequence (CpG) conjugated pro-
teins, Human immunoglobulin Fc-Fc fusion proteins,
and mannoside-conjugated protein (BSA).
Published: 12 August 2011
doi:10.1186/2045-7022-1-S1-S67
Cite this article as: Sampson: Immunotherapy of food allergy: what is
effective? Clinical and Translational Allergy 2011 1(Suppl 1):S67.
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Mount Sinai School of Medicine, Pediatrics, New York, USA
Sampson Clinical and Translational Allergy 2011, 1(Suppl 1):S67
http://www.ctajournal.com/content/1/S1/S67
© 2011 Sampson; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


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Immunotherapy of food allergy: what is effective?

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