Food Oral Immunotherapy
(OIT) Food Oral Immunotherapy
Food Oral Immunotherapy, or OIT, is the process of desensitizing a patient by ingesting increasing incremental amounts of an allergenic food in a monitored medical setting. The immune system is retrained to no longer react to the allergenic food. Food OIT has been studied in trials for over a decade and the concept of immunotherapy for environmental allergens has been in clinical practice for over a century.
Who is a good candidate for oral immunotherapy?
OIT has been successful in a wide range of ages and foods. Other allergic diseases such as asthma must be well controlled prior to starting desensitization. OIT is contraindicated in patients with eosinophilic esophagitis.
What is the process for oral immunotherapy?
There is an initial visit 2-3 weeks prior to onset of desensitization to review the protocol in detail and ensure that all other allergic diseases are well controlled. The first day of treatment is a build-up day, starting with a very small amount of allergen (i.e. 1/125,000th of a peanut) with increasing doses given every 20 minutes for several hours. The last tolerated dose is then ingested daily at home until the next incremental increase in the office in at least 7 day intervals. The food dose continues to increase with the goal of being able to freely eat the formerly allergenic food as desired at the end of the several month process. There typically is a food challenge at the end of the build-up phase to show that the patient can tolerate ingesting the usual serving size of the food while in the desensitized state.