A three-year study at Institute of Child Health Burlo Garofolo at the University of Trieste, led by Professor Alessandro Ventura, a long-time advocate of desensitisation for severe food allergies, resulted in 54% of the severely allergic children in the study being able to tolerate minimal quantities of allergic food in their diet, while 36% of the children involved were able to return to a normal diet.

The desensitisation took place in two stages. The first stage, where there is a major risk of severe reactions, lasted 10 days and took place in the hospital. During the hospitalisation, milk was administered at rapidly increasing doses, at two hour intervals, until at discharge the child was able to take 10 to 20ml of pure milk without adverse reaction. The second part took place at home, where the parents continued to give the children milk, once a day, at a much slower and more gradual rate of increase. Following the programme the children were able to tolerate ever increasing doses of milk, until they could follow a completely normal diet, usually within a year.

Are there any risks with this strategy? There were no fatal reactions during the programme but desensitisation can be accompanied by some complications and the clinic was available 24 hours a day for emergencies that might have occurred during the home phase of the protocol. However, given the potential benefits, the researchers felt that a small risk of complication was worth taking. Statistically, children who intentionally avoid the dangerous food occasionally come across the allergen when they often develop very severe reactions.

The study was reported in the Journal of Allergy and Clinical Immunology.

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First published in October 2008

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