Okay-- the upshot after talking with our allergist is that MOST research allergists
still don't believe in "resensitization" after a passed challenge.
They just don't.
The current party line is that "IgE rises with avoidance" and conversely, that it falls via exposure, and that therefore, if a person has both low IgE, a negative skin test,
and passes an IOFC, they are
tolerant-- they aren't allergic.
So what about those people-- and anyone in this community KNOWS they exist-- who dutifully go home and begin, as advised, feeding their newly non-allergic child that allergen, and the child complains about feeling funny... then
reacts objectively after a period of weeks or months?
I asked that question, by the way. His feeling is that during a challenge, that person probably WOULD be symptomatic somehow... and that maybe stricter criteria on what constitutes a pure "pass" could prevent that.
He also was very clear that the research/clinical community as a whole does NOT believe that regular consumption after a true passed IOFC ever results (well, "never" is a long time, but you know) in a redeveloped allergy.
Redeveloped allergies come from skin contact + avoidance. Period.
(This really surprised me. Of course, I probably surprised him by stating baldly that while I respect his opinion, I can't believe that it is 100% correct for everyone. In fact, I tartly pointed out at one point that I was pleased that physicians are seeing some of the things that
I have been hearing from distraught parents for about nine years now. Welcome to the impossible world of "my food allergy doesn't fit your theory."
)
About THIS study in particular:
a) no, not a surprise (to either of us, as noted he and I have had a number of conversations about OIT over the past four to five years)
b) no, not just milk... seems to be true in most of these studies to some degree
c) "there are just SO many unknowns still." (Said with some angst/dispirited affect-- he
wanted this to be the answer as much as anyone else did... after all, he's an allergy parent, too... but there are still SO many things that aren't known.)
Another interesting tidbit that I picked up from him-- and this one surprised me SO much that I asked him to repeat it and made a joke about it that my DD didn't appreciate, just to make S.U.R.E. I hadn't misunderstood him. Okay, so you know how common wisdom has it that anaphylaxis fills up the allergy cup and causes a person to be MORE reactive in the weeks after a reaction? He says-- not so. In fact, a SPT can be completely negative for a few weeks after anaphylaxis to the allergen, which is why he always waits.
I have no idea WHY that could be true. It certainly seems to run counter to a lot of on-the-ground, in-the-field experiences from a lot of people I know...
Is it possible that the drug cocktail given for anaphylaxis causes the suppression of the response?? I have no idea what to make of this. But I figured I'd pass it along.
The joke?
Oh, I wittily remarked that this sounds like a lovely desensitization technique without all of the cautions we usually ascribe to such efforts. Desensitization through anaphylaxis. Repeat as needed.
Yes, I have an odd sense of humor.