The Efficacy of a New Protocol of Oral Immunotherapy to Wheat for Desensitization and Induction of Tolerance

Samin Sharafian; Aliakbar Amirzargar; Mohammad Gharagozlou; Nima Parvaneh; Mansoureh Shariat; Marzieh Tavakol; Masoud Movahedi

doi:10.18502/ijaai.v21i3.9797

Samin Sharafian Department of Immunology and Allergy, Mofid's Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Aliakbar Amirzargar Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Gharagozlou Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Nima Parvaneh Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Mansoureh Shariat Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Marzieh Tavakol Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
Masoud Movahedi Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijaai.v21i3.9797

Keywords: Immune tolerance; Immunoglobulin E; Immunologic desensitization; Regulatory T-lymphocytes; Wheat hypersensitivity

Abstract

Oral immunotherapy (OIT) is a novel approach to desensitization and tolerance induction in food allergy patients. This study aimed to design and implement a new wheat OIT protocol, evaluate its efficacy in tolerance induction, and assess specific immunoglobulin-E (IgE) and regulatory T cell changes.

From 2015 to 2017, 26 patients with confirmed IgE-mediated hypersensitivity to wheat were treated via oral immunotherapy (OIT). Patients with prior anaphylactic episodes underwent OIT using the rush method. Specific IgE concentrations and the number of regulatory T cells (CD4+ CD25+ FOXP3+ T cells) were measured using Allergy Screen immunoblot assay and flow cytometry, respectively. This study was registered in the Iranian Registry of Clinical Trials (IRCT20181220042066N1).

The results revealed success rates of 100% and 93.3% for desensitization and tolerance. Specific IgE was significantly reduced after 12 months of OIT. No significant change in regulatory T cell numbers was observed.

In view of the promising findings of this study, the proposed OIT protocol could be viewed as an effective and valuable method to induce tolerance and desensitization in wheat allergic patients.