{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:10:03Z","timestamp":1778159403787,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For young children with fish allergy, dietary avoidance is the current standard of care. We aimed to assess whether codfish oral immunotherapy (OIT) can induce desensitization or sustained unresponsiveness (SU) in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a randomized, double\u2010blind, placebo\u2010controlled study in Hong Kong. Children aged 2\u201310\u2009years reactive to codfish protein during DBPCFC were randomly assigned 1:1 to codfish OIT or placebo for 52\u2009weeks (1000\u2009mg daily maintenance) followed by 8\u2009weeks avoidance. Primary outcome was desensitization at week 52; sustained unresponsiveness (SU) at week 60 was a key secondary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between November 2022\u2013September 2023, 70 children (median age 5.6\u2009years) were randomized to codfish OIT (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935) or placebo (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935). At the week 52 end\u2010of\u2010treatment challenges, 15 (43%) OIT participants versus 4 (11%) placebo achieved desensitization (risk difference 32%, 95% CI 9%\u201351%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), with significantly greater increases in cumulative tolerated protein [median 4330\u2009mg vs. 0\u2009mg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001]. At week 60, SU rates were 8 (23%) versus 3 (9%) (risk difference 14%, 95% CI \u22125% to 33%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.332). Codfish OIT significantly decreased codfish\u2010specific IgE, rGad c1\u2010specific IgE, and skin reactivity while increasing codfish\u2010specific IgG4. The treatment demonstrated acceptable safety with minimal moderate\u2010to\u2010severe adverse events and epinephrine use (3% both groups), and immunological evidence of reduced cross\u2010reactivity to salmon and catfish allergens.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In children with fish allergy, codfish OIT significantly increased desensitization rates compared to avoidance, though SU remained limited. The treatment demonstrated acceptable safety with predominantly mild reactions and reduced IgE cross\u2010reactivity to other fish allergens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT05590299\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.70268","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:36:48Z","timestamp":1771400208000},"page":"1799-1812","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Codfish Oral Immunotherapy in Children Aged 2\u201310: Randomized Placebo\u2010Controlled Study"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8249-4478","authenticated-orcid":false,"given":"Agnes Sze\u2010yin","family":"Leung","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Hong Kong Hub of Paediatric Excellence (HOPE) The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1142-8638","authenticated-orcid":false,"given":"Yanjun","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann Wing\u2010shan","family":"Au","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosetta Tsz\u2010ching","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa Hiu\u2010tung","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kin Yi","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3760-7918","authenticated-orcid":false,"given":"Janice Min","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2570-7745","authenticated-orcid":false,"given":"Christine Yee\u2010yan","family":"Wai","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Hong Kong Hub of Paediatric Excellence (HOPE) The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6469-1926","authenticated-orcid":false,"given":"Ting Fan","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Hong Kong Hub of Paediatric Excellence (HOPE) The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5939-812X","authenticated-orcid":false,"given":"Gary Wing\u2010kin","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong 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