Supplementary Material for: Safety and Efficacy of Low-Dose Oral Immunotherapy for Hen's Egg Allergy in Children

Background: The minimal dose for oral immunotherapy (OIT) tolerance is unknown. We investigated the efficacy and safety of low-dose OIT with 1/32 of the volume of a whole egg. Methods: Thirty-three children (aged ≥5 years) with egg allergies confirmed by oral food challenge against 1/32 of a heated whole egg (194 mg of egg protein) were enrolled. The OIT group ingested a scrambled egg once a day. The volume was gradually increased up to a maximum of 1/32 of a heated whole egg. Egg consumption was completely absent in the control group. Results: There were no significant differences in background between the OIT and control groups. Respectively, 71% (15/21) and 0% (0/12) of the patients in the OIT and control groups exhibited sustained unresponsiveness to 1/32 of a whole egg 2 weeks after stopping OIT after 12 months (p < 0.001); 33% (7/21) and 0% (0/12; p = 0.032), respectively, showed sustained unresponsiveness to 1/2 of a whole egg. Egg white- or ovomucoid-specific IgE levels in the OIT group were significantly lower than at baseline after 12 months. Egg white- or ovomucoid-specific IgG as well as IgG4 levels in the OIT group were significantly higher than baseline levels after 1, 3, 6, and 12 months. Adverse allergic reactions were rare, and most symptoms were mild. Conclusions: Low-dose OIT induced sustained unresponsiveness to 1/32 and 1/2 of a whole egg, with no severe symptoms. To improve food allergies, continuous intake of small amounts of these foods may be as effective as the consumption of larger quantities.背景：口服免疫疗法（oral immunotherapy, OIT）耐受所需的最小剂量尚未明确。本研究探讨了采用1/32全蛋体积的低剂量口服免疫疗法的有效性与安全性。 研究方法：本研究纳入了33名年龄≥5岁的鸡蛋过敏患儿，其过敏诊断经1/32加热全蛋（含194mg鸡蛋蛋白）的口服食物激发试验确认。口服免疫疗法组患儿每日食用1次炒鸡蛋，鸡蛋摄入量逐步递增，最大剂量为1/32份加热全蛋；对照组患儿完全不摄入鸡蛋类食物。 研究结果：两组患儿的基线特征无显著差异。在接受12个月口服免疫疗法并停药2周后，口服免疫疗法组与对照组分别有71%（15/21）与0%（0/12）的患儿对1/32份全蛋呈现持续无应答状态（p < 0.001）；两组分别有33%（7/21）与0%（0/12；p=0.032）的患儿对1/2份全蛋呈现持续无应答状态。口服免疫疗法组患儿在治疗12个月后，其卵清蛋白或卵黏蛋白特异性IgE水平较基线显著降低。在治疗1、3、6及12个月后，该组患儿的卵清蛋白或卵黏蛋白特异性IgG及IgG4水平均显著高于基线水平。不良过敏反应发生率较低，且多数症状轻微。 研究结论：低剂量口服免疫疗法可诱导患儿对1/32及1/2份全蛋产生持续无应答状态，且未出现严重不良反应。对于食物过敏的干预而言，持续少量摄入致敏食物或许与大量摄入的疗效相当。