A 5-year summary of real-life dietary egg consumption after completion of a 4-year egg powder oral immunotherapy (eOIT) protocol.
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ABSTRACT:
SUBMITTER: Kim EH
PROVIDER: S-EPMC7150643 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Publications
A 5-year summary of real-life dietary egg consumption after completion of a 4-year egg powder oral immunotherapy (eOIT) protocol.
Kim Edwin H EH Jones Stacie M SM Burks A Wesley AW Wood Robert A RA Sicherer Scott H SH Leung Donald Y M DYM Henning Alice K AK Lindblad Robert W RW Dawson Peter P Keet Corinne C Scurlock Amy M AM Plaut Marshall M Sampson Hugh A HA
The Journal of allergy and clinical immunology 20191224 4
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Project description: Not available
| S-EPMC6494514 | biostudies-literature
Project description:BackgroundFor egg allergy, dietary avoidance is the only currently approved treatment. We evaluated oral immunotherapy using egg-white powder for the treatment of children with egg allergy.MethodsIn this double-blind, randomized, placebo-controlled study, 55 children, 5 to 11 years of age, with egg allergy received oral immunotherapy (40 children) or placebo (15). Initial dose-escalation, build-up, and maintenance phases were followed by an oral food challenge with egg-white powder at 10 months and at 22 months. Children who successfully passed the challenge at 22 months discontinued oral immunotherapy and avoided all egg consumption for 4 to 6 weeks. At 24 months, these children underwent an oral food challenge with egg-white powder and a cooked egg to test for sustained unresponsiveness. Children who passed this challenge at 24 months were placed on a diet with ad libitum egg consumption and were evaluated for continuation of sustained unresponsiveness at 30 months and 36 months.ResultsAfter 10 months of therapy, none of the children who received placebo and 55% of those who received oral immunotherapy passed the oral food challenge and were considered to be desensitized; after 22 months, 75% of children in the oral-immunotherapy group were desensitized. In the oral-immunotherapy group, 28% (11 of 40 children) passed the oral food challenge at 24 months and were considered to have sustained unresponsiveness. At 30 months and 36 months, all children who had passed the oral food challenge at 24 months were consuming egg. Of the immune markers measured, small wheal diameters on skin-prick testing and increases in egg-specific IgG4 antibody levels were associated with passing the oral food challenge at 24 months.ConclusionsThese results show that oral immunotherapy can desensitize a high proportion of children with egg allergy and induce sustained unresponsiveness in a clinically significant subset. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT00461097.).
| S-EPMC3424505 | biostudies-literature
Project description:BackgroundHen's egg is one of the most common allergens causing infantile food allergy. Consuming heated egg yolk slightly contaminated with egg white (EY with scEW) improves diet quality. Most children with egg allergies can safely consume 1/25 of a heated whole egg (low-dose egg). Although low-dose egg has similar antigenicity to EY with scEW, clinical reproducibility is unknown. We aimed to examine the safety of EY with scEW consumption after a negative result of low-dose egg oral food challenge (OFC).MethodsIn this prospective study, children aged <18 years with a history of immediate reaction to eggs were enrolled. We advised children and guardians to consume EY with scEW after a negative result of low-dose egg OFC and to record symptoms, if any.ResultsWe evaluated 276 children with negative results for low-dose egg OFC who had previously shown reactivity to eggs. Their median age was 1.2 years. Boys accounted for 188 (68%) of the children. The median egg white-specific immunoglobulin E level was 11.7 kUA /L. At home, six children experienced mild symptoms. Skin symptoms were the most common. Among the six children, five were confirmed to continue the consumption of EY with scEW and one developed mild respiratory symptoms and continued to avoid eating eggs.ConclusionAlthough a few children with egg allergies experience mild symptoms, most of them can ultimately consume EY with scEW. Consumption of EY with scEW after low-dose egg OFC seems safe and may improve their quality of life by making egg yolk products available.
| S-EPMC7821144 | biostudies-literature
Project description:BackgroundWhile desensitization and sustained unresponsiveness (SU) have been shown with egg oral immunotherapy (OIT), the benefits of baked egg (BE) therapy for egg allergy have not been well studied.ObjectivesThis study sought to evaluate the safety and efficacy of BE ingestion compared with egg OIT in participants allergic to unbaked egg but tolerant to BE.MethodsChildren who are BE-tolerant but unbaked egg reactive ages 3 to 16 years were randomized to 2 years of treatment with either BE or egg OIT. Double-blind, placebo-controlled food challenges were conducted after 1 and 2 years of treatment to assess for desensitization, and after 2 years of treatment followed by 8 to 10 weeks off of treatment to assess for SU. Mechanistic studies were conducted to assess for immune modulation. A cohort of participants who are BE-reactive underwent egg OIT and identical double-blind, placebo-controlled food challenges as a comparator group.ResultsFifty participants (median age 7.3 years) were randomized and initiated treatment. SU was achieved in 3 of 27 participants assigned to BE (11.1%) versus 10 of 23 participants assigned to egg OIT (43.5%) (P = .009). In the BE-reactive comparator group, 7 of 39 participants (17.9%) achieved SU. More participants who are BE-tolerant withdrew from BE versus from egg OIT (29.6% vs 13%). Dosing symptom frequency in participants who are BE-tolerant was similar with BE and egg OIT, but more frequent in participants who are BE-reactive. Egg white-specific IgE, skin testing, and basophil activation decreased similarly after BE and egg OIT.ConclusionsAmong children allergic to unbaked egg but tolerant to BE, those treated with egg OIT were significantly more likely to achieve SU than were children ingesting BE.
| S-EPMC7554054 | biostudies-literature
Project description:ImportanceCholesterol is a common nutrient in the human diet and eggs are a major source of dietary cholesterol. Whether dietary cholesterol or egg consumption is associated with cardiovascular disease (CVD) and mortality remains controversial.ObjectiveTo determine the associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality.Design, setting, and participantsIndividual participant data were pooled from 6 prospective US cohorts using data collected between March 25, 1985, and August 31, 2016. Self-reported diet data were harmonized using a standardized protocol.ExposuresDietary cholesterol (mg/day) or egg consumption (number/day).Main outcomes and measuresHazard ratio (HR) and absolute risk difference (ARD) over the entire follow-up for incident CVD (composite of fatal and nonfatal coronary heart disease, stroke, heart failure, and other CVD deaths) and all-cause mortality, adjusting for demographic, socioeconomic, and behavioral factors.ResultsThis analysis included 29 615 participants (mean [SD] age, 51.6 [13.5] years at baseline) of whom 13 299 (44.9%) were men and 9204 (31.1%) were black. During a median follow-up of 17.5 years (interquartile range, 13.0-21.7; maximum, 31.3), there were 5400 incident CVD events and 6132 all-cause deaths. The associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality were monotonic (all P values for nonlinear terms, .19-.83). Each additional 300 mg of dietary cholesterol consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.17 [95% CI, 1.09-1.26]; adjusted ARD, 3.24% [95% CI, 1.39%-5.08%]) and all-cause mortality (adjusted HR, 1.18 [95% CI, 1.10-1.26]; adjusted ARD, 4.43% [95% CI, 2.51%-6.36%]). Each additional half an egg consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.06 [95% CI, 1.03-1.10]; adjusted ARD, 1.11% [95% CI, 0.32%-1.89%]) and all-cause mortality (adjusted HR, 1.08 [95% CI, 1.04-1.11]; adjusted ARD, 1.93% [95% CI, 1.10%-2.76%]). The associations between egg consumption and incident CVD (adjusted HR, 0.99 [95% CI, 0.93-1.05]; adjusted ARD, -0.47% [95% CI, -1.83% to 0.88%]) and all-cause mortality (adjusted HR, 1.03 [95% CI, 0.97-1.09]; adjusted ARD, 0.71% [95% CI, -0.85% to 2.28%]) were no longer significant after adjusting for dietary cholesterol consumption.Conclusions and relevanceAmong US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner. These results should be considered in the development of dietary guidelines and updates.
| S-EPMC6439941 | biostudies-literature
Project description: Not available
| S-EPMC7220838 | biostudies-literature
Project description:BackgroundStudies of long-term oral immunotherapy (OIT) in children with anaphylactic egg allergy are limited.ObjectiveOur aim was to investigate the long-term outcomes of OIT for anaphylactic egg allergy.MethodsThe participants included children (aged ≥ 5 years) with a history of anaphylaxis in response to eggs and objective reactions to oral food challenge (OFC) with 250 mg of egg protein. In the OIT group, the home starting dose of egg protein set during 5 days of hospitalization was ingested once daily and gradually increased to 1000 mg. Over the next year, participants temporarily discontinued OIT for 2 weeks and underwent OFC with 3100 mg of egg protein annually until they passed. The historical control group comprised patients who did not receive OIT and repeated OFCs annually.ResultsIn the OIT group (n = 20), the baseline median egg white- and ovomucoid-specific IgE levels were 45.5 and 38.5 kUA/L, respectively. The rate of passing OFC with 3100 mg of egg protein gradually increased in the OIT group, with rates of 20% at 1 year, 35% at 2 years, and 55% at 3 years, which were significantly higher than the rates in the historical control group at 3 years (5% [P < .001]). In the OIT group, 5 anaphylaxis events (0.04%) occurred at home, and 1 participant required intramuscular adrenaline. Furthermore, egg white- and ovomucoid-specific IgE levels decreased significantly after 3 years in both groups, whereas in the OIT group, these specific IgG and IgG4 levels increased significantly after a year.ConclusionLong-term OIT accelerated immunologic changes and enabled ingestion of 3100 mg of egg protein in half of the participants with anaphylactic egg allergy.
| S-EPMC10509875 | biostudies-literature
Project description:BackgroundThere is a large body of literature evaluating the impact of various nutrients of eggs and their dietary cholesterol content on health conditions. There is also literature on the costs of each condition associated with egg consumption. The goal of the present study is to synthesize what is known about the risks and benefits of eggs and the associated costs from a societal perspective.MethodsA risk apportionment model estimated the increased risk for coronary heart disease (CHD) attributable to egg cholesterol content, the decreased risk for other conditions (age-related macular degeneration (AMD), cataract, neural tube defects, and sarcopenia) associated with egg consumption, and a literature search identified the cost of illness of each condition. The base 795 case scenario calculated the costs or savings of each condition attributable to egg cholesterol or nutrient content.ResultsGiven the costs associated with CHD and the benefits associated with the other conditions, the most likely scenario associated with eating an egg a day is savings of $2.82 billion annually with uncertainty ranging from a net cost of $756 million to net savings up to $8.50 billion.ConclusionThis study evaluating the economic impact of egg consumption suggests that public health campaigns promoting limiting egg consumption as a means to reduce CHD risk would not be cost-effective from a societal perspective when other benefits are considered. Public health intervention that focuses on a single dietary constituent, and foods that are high in that constituent, may lead to unintended consequences of removing other beneficial constituents and the net effect may not be in its totality a desirable public health outcome. As newer data become available, the model should be updated.
| S-EPMC2672062 | biostudies-literature
Project description:BackgroundHen's egg allergy is among the most common food allergies in childhood and predicts later development of allergic disease. The optimal efficacy and mechanism(s) of egg allergen immunotherapy are poorly understood.ObjectiveTo enhance immunologic and clinical outcomes of egg oral immunotherapy (OIT) using a conditionally increased dosing strategy.MethodsIn an open-label clinical trial of egg OIT, egg-allergic children ingested daily doses of egg protein that were gradually increased based on the egg white (EW) IgE level. Skin prick test reactivity and EW- and ovomucoid-specific cellular and humoral responses were measured longitudinally. To confirm clinical tolerance, patients underwent double-blinded, placebo-controlled food challenges 1 month after completing the dosing protocol.ResultsChildren aged 3 to 13 years with characteristics of clinical egg allergy were enrolled. All 6 patients who completed the entire protocol developed clinical tolerance to egg during the study. The median wheal diameter on EW skin prick testing decreased from 10 to 2.5 mm during OIT (P = .03). Both EW and ovomucoid IgE levels significantly decreased during the study (median EW IgE level: from 18.8 kU/L at baseline to 3.9 kU/L, P = .03), and corresponding IgG4 levels increased (median EW IgG4 level: from 0.65 mg/L at baseline to 86.15 mg/L, P = .03). Transient increases were seen in egg-induced interleukin 10 (P = .06) and transforming growth factor β (P = .18) levels, and the ratio of T(H)2:T(H)1 cytokine production was decreased (P = .25).ConclusionsEgg OIT is associated with tolerance acquisition in children with persistent egg allergy. Individualized dosing regimens may be necessary to achieve a full therapeutic effect in some patients.
| S-EPMC3026291 | biostudies-literature
Project description:The purpose of this study was to investigate the effects of dietary Bopu powder supplementation on the serum antioxidant capacity, serum biochemical indices, egg quality, and intestinal microbiota. Six hundred and forty-eight 33-week-old Lohmann Brown commercial laying hens were randomly allocated into six groups and fed a basal diet supplemented with 0, 25, 50, 100, 200, and 400 mg/kg Bopu powder for 8 weeks, denoted BP0, BP25, BP50, BP100, BP200, and BP400, respectively. The results showed that dietary Bopu powder supplementation reduced serum cholesterol concentrations (linear, p < 0.01) while increasing serum globulin and albumin concentrations (linear, p < 0.05). Furthermore, the BP50 and BP100 groups had greater serum catalase and glutathione peroxidase activity (p < 0.05). The egg Haugh Units were considerably higher in BP25 and BP50 (p < 0.05), and eggshell thickness was higher in BP25, BP200, and BP400 (p < 0.05) when compared to BP0. Dietary treatment with Bopu powder at doses ranging from 25-100 mg/kg improved glutathione peroxidase and catalase activities while decreasing malondialdehyde concentrations in the yolk (p < 0.05). The addition of Bopu powder increased the diversity of microbiota and the relative abundance of Bacteroidota in the gut. For instance, dietary Bopu powder supplementation of 25-50 mg/kg significantly raised the relative abundance of Enterococcus, Bacteroides, and Fusobacterium in the foregut. Supplementing the diet with 50-100 mg/kg of Bopu powder improved the relative abundance of Lactobacillus in the hindgut. In conclusion, dietary Bopu powder supplementation enhanced the abundance of beneficial bacteria in the foregut of laying hens and improved egg quality and antioxidant capacity. Furthermore, in the laying hen diet, the optimal dosage of Bopu powder additive was 25-50 mg/kg.
| S-EPMC9353574 | biostudies-literature