Tolerance induction through early feeding to prevent food allergy in infants and children with sensitization against food allergens (TIFFANI): rationale, study design, and methods of a randomized controlled trial
Birgit Kalb,
Lara Meixner,
Stephanie Heller,
Sabine Dölle-Bierke,
Stephanie Roll,
Tatjana Tissen-Diabaté,
Susanne Lau,
Sofia Forslund,
Ingo Marenholz,
Young-Ae Lee,
Andreas Thiel,
Magda Babina,
Jörg Scheffel,
Margitta Worm,
Kirsten Beyer
Affiliations
Birgit Kalb
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Lara Meixner
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Stephanie Heller
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Sabine Dölle-Bierke
Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Stephanie Roll
Institute of Social Medicine, Epidemiology and Health Economics, , Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Tatjana Tissen-Diabaté
Institute of Social Medicine, Epidemiology and Health Economics, , Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Susanne Lau
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Sofia Forslund
Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité –, Universitätsmedizin Berlin
Ingo Marenholz
Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité –, Universitätsmedizin Berlin
Young-Ae Lee
Experimental and Clinical Research Center, a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité –, Universitätsmedizin Berlin
Andreas Thiel
BIH Center for Immunomics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Magda Babina
Institute of Allergology, Charité – Universitätsmedizin Berlin, a corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health
Jörg Scheffel
Institute of Allergology, Charité – Universitätsmedizin Berlin, a corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health
Margitta Worm
Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Kirsten Beyer
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin
Abstract Background Children with sensitization against foods have to be orally food-challenged before eating these foods for the first time. However, the waiting time for an oral food challenge (OFC) in Germany is about 3–6 months. In contrast, there are hints that an early introduction of allergenic foods might be protective regarding the development of food allergy. The aim of this clinical trial is therefore to investigate, whether an introduction and regular consumption of small amounts of food allergens is safe and will result in an increase of tolerance in children with sensitization against food allergens with unknown clinical relevance. Methods In this randomized, placebo-controlled, double-blind, single-center trial, 138 children (8 months to 4 years of age) sensitized to the target allergen(s) hen’s egg, cow’s milk, peanuts, and/or hazelnuts with unknown clinical relevance will be randomized in a 1:1 ratio to either an active or a placebo group, daily receiving a rusk-like biscuit powder with or without the target allergen(s) for 3–6 months until an OFC will be performed in routine diagnostics. The primary endpoint is an IgE-mediated food allergy to the primary target allergen, after the interventional period. Discussion Children with sensitization against food allergens with unknown clinical relevance often have to avoid the corresponding foods for several months until an OFC is performed. Therefore, the “window of opportunity” for an early preventive introduction of allergenic foods might be missed. This trial will assess whether an introduction of small allergen amounts will favor tolerance development in these children. Trial registration German Clinical Trials Register DRKS00032769. Registered on 02 October 2023.
