Supplementary Material for: Low-Dose Oral Immunotherapy Using Low-Egg-Allergen Cookies for Severe Egg-Allergic Children Reduces Allergy Severity and Affects Allergen-Specific Antibodies in Serum

Background: We evaluated the safety and efficacy of
low-egg-allergen cookies (LAC) as low-dose oral immunotherapy (OIT) in
children with severe egg allergy. We also examined the relationship
between mild desensitization by low-dose OIT and serum biomarkers of
allergy. Methods: We enrolled 13 children with egg allergy
who could not receive OIT with hard-boiled egg white (EW). For 11
participants, OIT was carried out using LAC for 3-4 months. Open food
challenges with hard-boiled EW and blood samplings were performed before
and after OIT. Participants were divided into 2 groups: high effect
(H-E) and no/low effect (N/L-E). Serum levels of total IgE and egg
yolk-, EW-, and ovomucoid (OM)-specific IgE, ovalbumin (OVA)- and
OM-specific IgG4, IgA1, and IgA2, and the percentage of CD 203c+ were measured. Results:
Allergic severity was reduced in 7 patients, who were assigned to the
H-E group. Moreover, no study participants were taken off the intake of
LAC during OIT. In the H-E group, OVA-specific IgA2 levels after OIT were significantly higher than before OIT. The ratios of OM-specific IgG4/OM-specific IgE and OM-specific IgA2/OM-specific IgE in the H-E group after OIT were significantly higher than before OIT. Conclusion: Our findings suggest that low-dose OIT using LAC is an effective and safe treatment for patients with severe egg allergy.