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

<b><i>Background:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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 (<i>p</i> &lt; 0.001); 33% (7/21) and 0% (0/12; <i>p</i> = 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. <b><i>Conclusions:</i></b> 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）诱导耐受的最小剂量尚不明确。本研究探究了1/32全蛋液剂量的低剂量口服免疫疗法的疗效与安全性。
**方法：** 本研究纳入33名年龄≥5岁的鸡蛋过敏患儿，所有患儿均经1/32加热全蛋液（含194mg鸡蛋蛋白）口服食物激发试验（Oral Food Challenge）确诊。口服免疫疗法组每日食用1次炒鸡蛋，剂量逐步递增，最终最大剂量为1/32加热全蛋液；对照组则完全不摄入任何鸡蛋类食物。
**结果：** 两组受试者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中分别有71%（15/21）、0%（0/12）的患者对1/32全蛋液表现出持续性无应答（*p* < 0.001）；两组分别有33%（7/21）、0%（0/12）的患者对1/2全蛋液表现出持续性无应答（*p* = 0.032）。治疗12个月后，口服免疫疗法组的卵清蛋白或卵粘蛋白特异性IgE水平较基线显著降低。在治疗第1、3、6、12个月时，口服免疫疗法组的卵清蛋白或卵粘蛋白特异性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。
**结论：** 低剂量口服免疫疗法可诱导患者对1/32及1/2全蛋液产生持续性无应答，且未出现严重不良反应。若要改善食物过敏状况，持续少量摄入致敏食物或许与大量摄入的疗效相当。