Current understanding of Egg Allergy and how effective is Oral Immunotherapy for Treatment of Egg Allergy in Children's.

Current understanding of Egg Allergy and how effective is Oral Immunotherapy for Treatment of Egg Allergy in Children's.

Author: Aalam Muntazim
(Karaganda Medical University)
AIM:
Make understanding about precautions for the egg Allergy.
ABSTRACT:
Egg is one of the very important allergens in nonage feeding, and egg allergy can cause worst quality of life concerns. A clear clinical history and the detection of egg with specific IgE will confirm the diagnosis of IgE-mediated reactions.
Where Oral immunotherapy is an emerging treatment of IgE-mediated egg allergy now a days.
Many of the studies have shown the potential for egg OIT to induce and encourage clinical desensitization.
Recent studies proved that using of reduced allergenic egg products and the anti-IgE assisted therapy to improve egg Allergy.
OIT safety will also be discussed. 
Keywords: allergic reaction, Anaphylaxis, egg containing vaccine.

Introduction:
What is egg allergy?
Egg allergy is an IgE-mediated type of Allergy and healthy individuals are able to generate antigen-specific IgE on exposure to egg allergens.
Prevelance?
Egg allergy is one of the most common food allergies encountered in pediatric world with an prevalence of almost 0.5 to 2% in infants and young children.

Symptoms:
Symptoms of egg allergy extent from mild to the severe allergic reaction (called anaphylaxis). The most common symptoms of egg allergy are seen with allergic skin reactions. Other symptoms which include runny nose, itchy and watery eyes (like in hay fever), cramps, nausea and vomiting.

Anaphylaxis is mostly likely to be occurring when any one of the following situations(down) happens within minutes to hours after ingestion of the egg allergen in the body.
When A person with the conditions like have symptoms that involve the skin, nose, mouth or gastrointestinal tract and either:
Difficulty in the breathing, 
Reduced blood pressure (pale, weak pulse, confusion, loss of consciousness)
When a person is exposed to a suspected allergen, and two or more of the following will occur:
Skin symptoms(red rashes and inflammation or swollen lips)
Difficulty in breathing
Reduced BP
Gastrointestinal symptoms like: vomiting, diarrhea, cramping.
when a person was exposed to a already known allergen, and he experiences:
Reduced BP
leading to weakness and fainting.
Evaluation:
Any evaluation of suspected egg mislike should always begin with a history and physical examination of the patient.
Diagnostic evaluation
Individual who undergo evaluation for egg allegy must includes skin testing( in which small amounts of allegen that is egg proteins are introduced subcutaneously and covered for response), egg-specific serum IgE situations, and oral food challenges. Although food journals( a written log for the patient that he consumes) are non-diagnostic, they can be useful in relating egg as a implicit allergen. Among the diagnostics evaluations for egg allergy, the double-blinded, placebo- controlled oral food challenge is considered the gold standard for assessment and opinion of suspected egg allergy.
Unlike egg-specific serum IgE situations, the oral food challenge should be done under the close supervision and trained professional for the covering of significant possibility of anaphylaxis.
Vaccines containing egg protein
Previously, the influenza or flu vaccine has contained a small amount of egg protein. In now vaccines, this is no longer the case. The Centers for Disease Control and Prevention (CDC) do not recommends that egg-antipathetic individualities avoid the flu vaccine or receive any special testing prior to administration. It is recommended that all individuals must receive this vaccine annually.
The yellow fever vaccine also contains some egg protein. Both the WHO and CDC state that a severe egg allergy is a contraindication for that vaccine. Yellow fever is mostly found in parts of Africa and South America; the vaccine may be required for travel to countries where the disease is found. If needed, your doctor can provide a waiver letter for the vaccine requirement
. 
The un fever vaccine also contains egg protein. Both the World Health Organization and CDC state that a severe egg mislike is a contraindication for that vaccine. unheroic fever is most generally set up in corridor of Africa and South America, the vaccine may be needed for trip to countries where the complaint is found. However, your practitioner can give a disclaimer letter for the vaccine demand If demanded.
Management:
The best to manage egg allergy is take precautions and avoid eating of eggs.
Unfortunately, eggs are a hidden ingredient in many foods, like canned soups, salad, chocolates, ice creams and many meat-based foods like meatballs and meatloaf. Even some commercial egg substitutes contain egg protein.
Egg is one of eight food allergens with conditions under the Food Allergen Labeling and Consumer Protection Act of 2004. That law requires manufacturers of packaged food products sold intheU.S. and containing egg as an element to include the presence of egg or egg products, in clear language, on the element marker.
Anyone diagnosed with an allergy to either egg whites or egg yoke should avoid eggs altogether; it is not possible to completely separate the egg white from the yolk.
People with an egg allergy can sometimes tolerate baked goods and other foods containing eggs that have been toast for a prolonged period at a high temperature. Still, there is no way to predict when, or whether, an egg-antipathetic existent can safely tolerate any productcontainingeggs.However, or your child is, ask an allergist which foods must be avoided, If youre antipathetic to eggs.
Antihistamines  that may help to relieve mild symptoms of egg allergy, such as itching.
Oral immunotherapy (OIT) is a potential treatment option for individuals with egg allergy. It involves gradually exposing the person to increasing amounts of egg protein over time, with the goal of desensitizing their immune system to egg allergens. The treatment is typically administered under medical supervision to ensure safety.

During OIT, a person with an egg allergy consumes small, controlled doses of egg protein, usually starting with a tiny amount and gradually increasing over several months. The process aims to train the immune system to tolerate egg proteins without triggering an allergic reaction. The goal is to reach a maintenance dose where the person can consume a certain amount of egg without experiencing an allergic reaction.

The effectiveness of OIT for egg allergy varies among individuals. Some studies have reported success in desensitizing individuals to egg allergens, allowing them to consume eggs without adverse reactions. However, it's important to note that the treatment does not provide a permanent cure for egg allergy in most cases. Discontinuing OIT or consuming large amounts of egg after the treatment can lead to the re-emergence of allergic symptoms.

It's crucial to emphasize that oral immunotherapy for egg allergy should only be conducted under the supervision of an allergist or other qualified healthcare professionals experienced in managing food allergies. They can assess the suitability of the treatment for each individual, monitor progress, and address any potential side effects or adverse reactions.

It's also worth mentioning that research and medical advancements continue to evolve. New treatments, therapies, or approaches may emerge over time, so it's essential to consult with healthcare professionals for the most up-to-date information and recommendations regarding oral immunotherapy for egg allergy.

Allergist may prescribe Adrenaline as an auto-injector, to be taken when you develop symptoms of anaphylaxis (a potentially fatal reaction) that includes shortness of breath, swelling of the throat, and dizziness from a  drop in BP.
Your allergist must thought you how to use the auto-injector, which should be with you at all times and used as soon as symptoms start to appear. 
Emergency treatment for severe allergic reactions (anaphylaxis)
Emergency responses for anaphylaxis are:
Lay the person flat don't allow them to stand or walk. 
Administer adrenaline with an injecto into the external mid-thigh. 
Can be further if there's no response after 5 minutes
Give adrenaline first, also asthma reliever puffer, if needed. 
If you're at threat of anaphylaxis make sure you 
Have an Australasian Society of Clinical Immunology( ASCIA) Action Plan for Anaphylaxis. 
Have an adrenaline injector to treat a severe antipathetic response. 
Avoid drug( where possible) that may increase the inflexibility of antipathetic response or complicate its treatment similar as beta blockers. 
Avoid the food which causes your antipathetic response. 
Tell food staff about your allergy when eating out. 
Seek medical advice from a experts.
or clinical immunology/ allergy specialist.
Now a days Adrenaline autoinjectors are also available over the counter from a pharmacy.
Conclusions:
In conclusion, the most of the patient with egg allergy develop tolerance over time, so that why repeated egg challenge tests are must required for determine the tolerance acquisition. The scheduling a challenge test must not be too early or too late to avoid unnecessary testing and unjustified restriction diet, which may impaired or retard the growth and development. Integration of careful history of clinical characteristics and serologic markers can provide insights into the natural history as well as information for planning an appropriate time to perform the tests (blood and/or challenge).

References:
Caubet JC, Wang J. Current understanding of egg allergy. Pediatr Clin North Am. 2011 Apr;58(2):427-43, xi. doi: 10.1016/j.pcl.2011.02.014. PMID: 21453811; PMCID: PMC3069662 Mathew P, Pfleghaar JL. Egg Allergy. [Updated 2022 Jul 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: 
Better health channel Reviewed on: 11-04-2022

ASCIA dietary avoidance for food allergy, Australasian Society of Clinical Immunology and Allergy (ASCIA).
ASCIA action plans for anaphylaxis and allergic reactions: FAQ, Australasian Society of Clinical Immunology and Allergy (ASCIA).
ASCIA action plans and first aid plans for anaphylaxis, Australasian Society of Clinical Immunology and Allergy (ASCIA)
Fare.
American college of allergy,asthma and immunology.
page was reviewed for accuracy 3/21/2019.