SO-CMA · Improving the safety of oral immunotherapy for cow's milk allergy in children
Horizon 2020 — Marie Skłodowska-Curie Actions
- Duration
- 2016-03-07 → 2019-05-29
- EU contribution
- €183,455
- Participants
- 1
- Scheme
- MSCA-IF
Lines connect the coordinator with its partners.
Results in brief
Improving the safety of oral immunotherapy for cow's milk allergy in children
Cow’s Milk allergy (CMA) is the most common food allergy in young children. After nuts, it is also the most common cause of death due to allergic reactions in children in the UK. Food allergy has a major impact on quality of life, due to the fear of having an unpredictable life-threatening reaction, and the dietary restrictions needed to reduce this risk. Milk is a common ingredient in our diets, so avoidance can be very difficult. There is no treatment for CMA- day-to-day management involves avoiding all dairy and having rescue medication (such as an adrenaline ‘pen’) available. Many children outgrow their CMA by school age, but recent reports show that up to half will continue to be allergic in adulthood. Children with persisting CMA often have more severe reactions. A different approach to managing CMA is immunotherapy. This involves trying to “re-train” the immune system not to react to milk. One way to do this is to give increasing amounts of milk every day for several months, known as oral immunotherapy (OIT). An alternative is to keep the milk under the tongue for a few minutes every day, rather than simply swallow it. This approach, known as sublingual immunotherapy (SLIT), is very effective for non-food allergies, such as hayfever. OIT can be effective for CMA, but it can cause frequent reactions. SLIT causes very few reactions but it doesn’t have as big an effect in changing the amount of milk tolerated after treatment. The main objective of this action was to develop a safe and effective treatment for children with persistent CMA. Specifically, to explore whether using SLIT followed by OIT is a better way of doing immunotherapy, without causing significant reactions. A number specific objectives was established (see below). The action duration was 24 months. Early termination occurred in month 7 due the fellow being appointed to a substantive clinical/academic position.
Data: CORDIS, © European Union
Project objective
Background: Food allergy affects 6% of children in the EU, and has a major impact on quality of life, nutrition, health-economics and the food production industry. Cow’s milk (CM) is a common cause, and can be particularly problematic due to the ubiquitous nature of CM in foods. Strict dietary avoidance is difficult to achieve, and unpredictable life-threatening accidental reactions are common, leading to anxiety and social restrictions for patients and families. Oral immunotherapy (OIT) has been shown to be efficacious but is not widely accepted as routine treatment, due to significant safety concerns – allergic reactions are common, and can be particularly severe in CM-OIT. Objective: To improve the safety of OIT for CM allergy. Proposed methods: WP1 - Systematic review of the literature to identify features of published OIT protocols that are associated with improved safety. WP2 - Assessment of human immune responses to candidate modified CM proteins (proven to be both non-allergenic and tolerising in murine models) as potential tools for immunotherapy. WP3. Phase 2/3 clinical trial to assess whether a sublingual pre-treatment phase can improve the safety of OIT in CM allergic children. Deliverables: 1) Systematic review to identify features of CM-OIT associated with improved safety. 2) Evidence on the immunogenicity of candidate modified CM proteins in humans, which will reflect their suitability as immunotherapy agents in the future. 3) Data relating to whether an initial sublingual phase can improve the safety of CM-OIT. 4) Pilot data on mechanisms underlying the immune-modulation induced by OIT. 5) Skills transference to the applicant to become a highly qualified independent researcher, with expertise in OIT for food allergy at an International level. 6) Consolidation of the host institution as a centre of excellence in food immunotherapy, including the potential for tolerising modified proteins to improve OIT safety and efficacy.
Original text from CORDIS.
Participants
- IMPERIAL COLLEGE OF SCIENCE TECHNOLOGY AND MEDICINE · LondonCoordinatorUnited Kingdom
Links
Data: CORDIS, © European Union