University of Oulu

Kulmala, P., Pelkonen, A.S., Kuitunen, M., Paassilta, M., Remes, S., Schultz, R., Dunder, T., Turunen, S. and Mäkelä, M.J. (2018), Wheat oral immunotherapy was moderately successful but was associated with very frequent adverse events in children aged 6–18 years. Acta Paediatr, 107: 861-870. doi:10.1111/apa.14226

Wheat oral immunotherapy was moderately successful but was associated with very frequent adverse events in children aged 6-18 years

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Author: Kulmala, Petri1,2; Pelkonen, Anna S.3,4; Kuitunen, Mikael5;
Organizations: 1PEDEGO Research Unit, Medical Research Center (MRC) Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
2Biomedicine Research Unit, Clinical Microbiology and Immunology, University of Oulu, Oulu, Finland
3Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
4University of Helsinki, Helsinki, Finland
5Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
6Allergy Center, Tampere University Hospital, Tampere, Finland
7Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
8Pihlajalinna Medical Center, Tampere, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe202001131856
Language: English
Published: John Wiley & Sons, 2018
Publish Date: 2020-01-13
Description:

Abstract

Aim: This study investigated oral immunotherapy (OIT) for children aged 6–18 years with wheat allergies.

Methods: Well‐cooked wheat spaghetti was given to 100 children with wheat allergies every day for 17 weeks, increasing from 0.3 to 2000 mg of wheat protein, followed by three‐ and nine‐month maintenance phases. Blood samples were taken before therapy and at follow‐up visits. The study was carried out in 2009–2015 in four Finnish paediatric allergology units.

Results: The children (67% male) had a mean age of 11.6 years (range 6.1–18.6), and 57 were using wheat daily 16 months after the initiation of therapy. Allergic symptoms occurred in 94/100 children: mild in 34, moderate in 36 and severe in 24. Specific immunoglobulin E (IgE) for ω‐5‐gliadin was significantly higher in patients who did not reach the target dose and were related to the intensity of reactions.

Conclusion: The majority (57%) of children with wheat allergies could use wheat in their daily diet 16 months after the initiation of OIT, but 94/100 had adverse reactions and 60 were moderate or severe. Specific IgE to ω‐5‐gliadin may provide a biomarker for how much wheat can be tolerated and the intensity of the reactions to immunotherapy.

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Series: Acta pædiatrica
ISSN: 0803-5253
ISSN-E: 1651-2227
ISSN-L: 0803-5253
Volume: 107
Issue: 5
Pages: 861 - 870
DOI: 10.1111/apa.14226
OADOI: https://oadoi.org/10.1111/apa.14226
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: This work was supported by the research grants from the Alma and K.A. Snellman Foundation, the Finnish Medical Association, the Allergy Research Foundation and the Finnish Pediatric Research Foundation.
Copyright information: © 2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Kulmala, P., Pelkonen, A.S., Kuitunen, M., Paassilta, M., Remes, S., Schultz, R., Dunder, T., Turunen, S. and Mäkelä, M.J. (2018), Wheat oral immunotherapy was moderately successful but was associated with very frequent adverse events in children aged 6–18 years. Acta Paediatr, 107: 861-870, which has been published in final form at doi:10.1111/apa.14226. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.