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Clinical Reviews in Allergy & Immunology

, Volume 55, Issue 2, pp 153–161 | Cite as

The Current State of Epicutaneous Immunotherapy for Food Allergy: a Comprehensive Review

  • Bruce J. Lanser
  • Donald Y. M. Leung
Article

Abstract

The food allergy epidemic of recent years has led to the search for safe and effective methods of immunotherapy for foods. Studies of epicutaneous immunotherapy (EPIT) in mice have shown promising safety and efficacy data. Murine models have also identified probable mechanisms for the development of tolerance to food allergens, including the induction of regulatory T cells. Clinical data is lacking, but relatively small and early studies among peanut and cow’s milk allergic subjects suggest that EPIT has an excellent safety profile, particularly compared to other methods of specific allergen immunotherapy. Efficacy data are also promising for peanut allergy, among younger patients (ages 4–11 years of age), suggesting that a majority of young patients will experience an increase in reaction threshold with therapy. The goal of this therapy is the protection from accidental exposures to a known food allergen. Additional clinical data is needed to prove efficacy and further demonstrate the safety profile of EPIT for food allergy, prior to approval by the Food and Drug Administration.

Keywords

Food allergy Immunotherapy Epicutaneous immunotherapy Sublingual immunotherapy Oral immunotherapy Anaphylaxis 

Abbreviations

EPIT

epicutaneous immunotherapy

OIT

oral immunotherapy

SLIT

sublingual immunotherapy

SU

sustained unresponsiveness

OFC

oral food challenge

DBPC

double-blind, placebo-controlled

TAAEs

treatment associated adverse events

CTD

cumulative tolerated dose

SCD

successfully consumed dose

EDS

epicutaneous delivery system

DCs

dendritic cells

LN

lymph node

EoE

eosinophilic esophagitis

VEDS

Viaskin® epicutaneous delivery system

SCIT

subcutaneous immunotherapy

FDA

Food and Drug Administration

RCT

Randomized controlled trial

Notes

Compliance with Ethical Standards

Conflict of Interest

BJL and DYML have received research support from DBV Technologies, and participate in CoFAR, funded by NIAID/NIH. BJL has received research support from AImmune Therapeutics, has formerly received a speaker honorarium from Mylan, and served as a consultant to AImmune Therapeutics. DYML is the chair of the AImmune Therapeutics DSMB for phase 3 clinical trials.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Allergy and Clinical ImmunologyNational Jewish HealthDenverUSA

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