Oral Immunotherapy for Egg Allergy

Understanding Research for Treatment

Will you ever be able to eat eggs?. Simon McComb/Getty Images

A food allergy to egg is most common in children. There’s an eighty percent chance that young children will outgrow egg allergy by the time they are 5 years old. More recent research indicates about half of children with egg allergy will not outgrow it until 10 years old. The good news--most will outgrow it by adolescence. Accidental ingestion of egg imparts the biggest concern and risk for these individuals and their parents.

Oral immunotherapy (OIT) is an area of research investigation that aims to find a way to “immunize” children with egg allergy against allergic reaction. In oral immunotherapy for egg allergy, individuals are introduced to the egg allergen in small incremental doses, usually in a powder form, under physician supervision (mainly within research studies) in order to desensitize, or build tolerance, to the egg allergen.

While there is no approved clinical treatment for egg allergy at this time, other than complete avoidance of egg and foods made with egg, oral immunotherapy for egg allergy is a potential way to prevent adverse reaction to accidental ingestion of egg, and may hold promise as a cure for egg allergy, but more research is needed.

Executing Egg Immunotherapy

When individuals participate in research studies with egg oral immunotherapy, they typically eat egg white powder that has been mixed into a safe food.

It is given in very small doses, every day at the same time, and the dose is incrementally increased to a maintenance dose level. This maintenance dose is carried on daily for a specified amount of time, depending on the study protocol.

Researchers look for tolerance to the egg dose, and specifically keep an eye on allergic reaction symptoms, which can range from mild (hives, redness and itchiness of the skin) to severe (swelling of the back of the throat, trouble breathing, drop in blood pressure, and faintness or dizziness).

The Research

A 2007 study by Buchanan et al looked at 7 children with egg allergy and no history of anaphylaxis. These children underwent 24 months of egg oral immunotherapy. The researchers concluded that the participants were not increasingly sensitized to egg, and three subjects with known accidental ingestion of egg did not experience a negative reaction. All study participants tolerated more egg protein than at the onset of the study. Two participants demonstrated oral tolerance to egg.

A 2012 study by the Consortium of Food Allergy Research (COFAR) which includes study sites from New York City, Little Rock, AR, Baltimore, MD, Denver, CO and Chapel Hill, NC, appearing in the New England Journal of Medicine, reported results from a study using egg white powder given to 40 highly egg allergic children, aged 5 to 11 years, in increasing doses every 2 weeks until they were eating the equivalent of 1/3 of an egg. The control group of 15 egg allergic children (same age) received cornstarch in the same amounts and incremental doses.

All children were followed for 24 months.

After 10 months of egg oral immunotherapy, 55% of egg allergic children were desensitized to egg, while none of the cornstarch children were. After 22 months on oral immunotherapy, 75% of egg allergic children were desensitized to egg.  After OIT was completed, the participants were removed from daily OIT and retested 4-6 weeks later. Twenty-eight percent (about 11 kids) passed a food challenge at 24 months and were considered sustained unresponsive (no reaction to egg allergen). They were allowed to eat egg in their diet as much as they wanted. At a one year follow-up, they reported no symptoms to egg.

At 30 and 36 months, all kids who passed the food challenge in this study were eating eggs. The authors of the study concluded that OIT for egg allergy may desensitize a high proportion of children with egg allergy and induce sustained unresponsiveness.

The authors of the study were cautious and measured about the results, however, stating that “having 28% achieve sustained unresponsiveness off daily treatment is encouraging, but more studies are needed to determine if this observation reflects a treatment “cure” or natural course of the allergy.”

Egg OIT and other food OIT, like peanut and milk, should not be tried at home, nor should they be done in a clinical environment, as this is not accepted as a treatment mode for food allergy yet. It is under investigation, and all researchers to date indicate more research is needed.


Sicherer SH. Food Allergies: A Complete Guide for Eating When Your Life Depends on It. 2013. The Johns Hopkins University Press. Baltimore, MD.

Buchanan AD et al. Egg oral immunotherapy in non-anaphylactic children with egg allergy. J Allerg Clin Immunol. 2007; 119(1): 199-205.

Burks AW, Jones SM, and Wood RA. Oral Immunotherapy for Treatment of Egg Allergy in Children. N Engl J Med. 2012; 367(3): 233-243.

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