Abstract
Food allergic children are recently allowed to consume the causative food within safety limits that are set based on their oral food challenge (OFC) results. In this article, we review the results of tolerance induction effect by avoiding complete elimination. 1) Early introduction of one cooked egg yolk with slight contamination of egg white: Subjects who consumed the egg starting at age 0 to 1 had a higher rate of egg tolerance at age 5 than subjects starting at age 2 to 3. 2) Small amount induction of cow's milk or wheat: One year after passing small amount OFC, approximately 10% of cow's milk allergy and 30% of wheat allergy achieved tolerance. 3) Small amount induction oral immunotherapy: We enrolled children who failed in small amount OFC. The maintenance dose was smaller compared with that of reported oral immunotherapy. One year after small amount induction oral immunotherapy started, approximately 30% of cow's milk allergy, 50% of hen's egg allergy, and 100% of peanut allergy achieved moderate amount tolerance. Our studies suggest that avoidance of complete elimination would induce tolerance of food allergy. In comparison with natural outgrow, we need to investigate the effect in a prospective study.
