Grant: Project Grant

It is estimated that 7% of Canadian children under age 18 years have a food allergy. Food allergy can trigger severe allergic reactions and is the major cause of fatality related to severe allergic reactions. Oral Immunotherapy (OIT) has been recently shown to reduce, or eliminate, the frequency and severity of these adverse allergic reactions in children. OIT is a treatment for food allergy where the patient eats a small amount of the allergen daily. This dose is incrementally increased over time. This continues until a predetermined quantity of the allergen can be consumed without an adverse reaction. At this point the patient is protected from adverse events due to accidental exposures. This level of protection is typically acquired in 6 to 24 months depending on the patient response and the allergen and methodology used. However, OIT use is currently limited, mainly due to high risk of allergic reactions and even fatality associated with its use. The goal of our study is to develop new protocols that will promote a safer and effective strategy for OIT. We hypothesize the proportion of anaphylactic reactions will be at least 5 times lower among participants managed through our modified protocols We will test our hypothesis using two aims: 1) Develop modified protocols that will improve the safety of OIT while maintaining its efficacy. Modified protocols will include protocols based on lower doses and protocols using baked form of the food allergens. We will compare the number of severe adverse reactions on two modified protocols vs the standard protocol in use today. 2) Determine the long-term protective effect of OIT. Using a 5 year follow up period we will assess the long-term effectiveness of OIT in our patients. The proposed research program will be the first to strategically examine the effectiveness of different OIT protocols and will contribute to future safe and effective protocols that will be incorporated in clinical practice.