Monatsschrift Kinderheilkunde

, Volume 154, Issue 5, pp 432–438

Spezifische orale Toleranzinduktion bei Nahrungsmittelallergie

  • U. Staden
  • C. Rolinck-Werninghaus
  • K. Beyer
  • B. Niggemann
Leitthema
  • 132 Downloads

Zusammenfassung

Eine spezifische orale Toleranz bei Nahrungsmittelallergie kann durch orale, allmählich steigende Gaben des allergenen Nahrungsmittels induziert werden. Bislang liegen nur wenige Studien mit kleinen Fallzahlen vor; sie zeigten jedoch für Kuhmilch und Hühnerei eine gute Effektivitätrate, bislang ohne erhebliche allergische Nebenwirkungen. Dieser Beitrag gibt einen Überblick über bisherige Studien, erläutert kurz mögliche immunologische Mechanismen, beschreibt verschiedene Reaktionsmuster und diskutiert Vor- und Nachteile und die Bedeutung von spezifischer oraler Toleranzinduktion (SOTI). Derzeit ist SOTI zur Routineanwendung in der Praxis noch nicht geeignet. Zukünftig könnte sie jedoch eine Alternative zur Eliminationsdiät sein, mit den Vorteilen einer verbesserten Lebensqualität und erhöhten Sicherheit für die Patienten. Mit kontrollierten Langzeitstudien an größeren Fallgruppen muss geprüft werden, wie Patienten am besten von SOTI profitieren und welche immunologischen Mechanismen der oralen Toleranzinduktion zugrunde liegen.

Schlüsselwörter

Orale Toleranz Nahrungsmittelallergie Kinder Immuntherapie Spezifische orale Toleranzinduktion (SOTI) 

Abkürzungen

DBPCFC

Doppelblinde, plazebokontrollierte Nahrungsmittelprovokation

Ig

Immunglobulin

SOTI

Spezifische orale Toleranzinduktion

Th-Zelle

T-Helfer-Zelle

Specific oral tolerance induction (SOTI)

Abstract

Specific oral tolerance in food allergy can be induced by oral administration of gradually increasing dosages of the offending food. So far, only a few studies on a limited number of patients are available. However, these show good results regarding cow’s milk and hen’s egg allergies, with high efficacy rates and without relevant side effects so far. This article gives an overview of the published studies, provides insight into possible immunological backgrounds, describes different patterns of reaction, and discusses the pros, cons, and possible implications of specific oral tolerance induction (SOTI). At present, SOTI cannot be administered routinely in daily practice. However, in the near future, SOTI could be an alternative to the strict elimination diets presently used, with the advantages of better quality of life and increased safety for the patients. Controlled, long-term studies using larger numbers of patients are needed in order to show who could profit from SOTI and to understand the underlying immunological mechanisms.

Keywords

Oral tolerance Food allergy Children Immunotherapy Specific oral tolerance induction (SOTI) 

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  • U. Staden
    • 1
  • C. Rolinck-Werninghaus
    • 1
  • K. Beyer
    • 1
  • B. Niggemann
    • 1
  1. 1.Klinik für Pädiatrie mit Schwerpunkt Pneumologie und ImmunologieCharité – Universitätsmedizin Berlin, Campus Virchow-KlinikumBerlin

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