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Safety review of Year 1 Oral Immunotherapy Clinic: Multifood Immunotherapy in Real-World setting
... Most data on OIT safety and efficacy come from clinical trials for peanut allergy, the largest of which is a recently published Phase 3 international trial [47,48]. This study showed that six months after achieving a maintenance dose of 300 mg (approximately one peanut), 67.2% of participants receiving active treatment were able to ingest 600 mg or more of peanut protein without dose-limiting symptoms compared to 4% of placebo-treated participants. ...
Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food—along with general diagnostic and therapeutic strategies. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning their correct management. We conclude that a correct diagnostic approach and dietary control of both immune- and non-immune-mediated food-induced diseases might minimize the nutritional gaps in these patients, thus helping to improve their quality of life and reduce the economic costs of their management.
Standard criteria for ideal patient selection with food oral immunotherapy (OIT) have yet to be determined. Although there are a handful of contraindications to consider before recommending OIT, most patients with confirmed immunoglobulin E‐mediated food allergies are appropriate candidates. Success rates of OIT can vary widely and be influenced by several factors. Choosing the most appropriate candidate for an OIT program can mitigate risks and provide the best chance for patients to be successful.
Objective:
To summarize the current literature of the psychological impacts of coronavirus disease 2019 (COVID-19) on people with allergic diseases and to identify gaps in need of future research.
Data sources:
Ovid MEDLINE(R) and Embase Classics + Embase from 1947 to present (October 18, 2021) were searched using a search strategy that included the following keywords: allergic diseases, covid*, and psychological disorders.
Study selections:
Primary manuscripts and abstracts using online and telephone surveys, mixed-method studies capturing patient and caregiver experiences, case studies, and published guidelines from allergic disease-specific expert groups were included.
Results:
People with asthma and other chronic respiratory conditions are at higher risk of negative psychological outcomes, and risk factors include asthma severity, female sex, and previous history of anxiety and depression, likely owing to the perceived risk of severe disease from COVID-19. One study identified that people with allergic rhinitis had significantly high anxiety and depression scores compared with healthy controls (both, P < .001). The psychological impacts of food allergy during COVID-19 were most strongly felt by parents and caregivers. Similarly, parents of children with asthma experienced substantial psychological burden.
Conclusion:
COVID-19 had a considerable psychological impact on patients with asthma. Limited data have been published on the mental health impacts of COVID-19 on patients with allergic rhinitis and food allergy. As COVID-19 research continues to evolve and the literature captures later stages of the pandemic, it is important that physicians be aware of the potential coincidence of mental illness and chronic allergic diseases and refer these patients, and their caregivers, to appropriate resources while also continuing to manage their allergic disease(s).
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