New approach for improving the safety of oral immunotherapy for food allergy

Avoidance of causative foods is the mainstay of therapy for food allergy. This therapy places a burden, to a greater or lesser extent, on food-allergic patients and their parents if they are children. They always face the probable risk of an unexpected accident resulting from intake of a causative food. Allergen-specific immunotherapy for pollinosis and bee-venom allergy has been proven efficient and common in clinical practice. Recently, reports on oral immunotherapy (OIT) for food allergy have been increasing, and OIT has drawn attention as a therapy with the possibility of providing a cure for food allergy. Initially, we review the present status of oral antigen-specific immunotherapy for food allergy. Overall, OIT for food allergy is promising with regard to an increase in tolerance to causative foods. However, several concerns regarding safety remain. Subsequently, we review new approaches for improving the safety of OIT, including sublingual immunotherapy and modified antigens for OIT. We briefly summarize our study on OIT using heated and ovomucoid-reduced egg white as an example of a hypoallergenic antigen for safer OIT.