Advances in the approach to the patient with food allergy

J Allergy Clin Immunol. 2018 Jun;141(6):2002-2014. doi: 10.1016/j.jaci.2017.12.1008. Epub 2018 Mar 8.

Abstract

Advances in food allergy diagnosis, management, prevention, and therapeutic interventions have been significant over the past 2 decades. Evidence-based national and international guidelines have streamlined food allergy diagnosis and management, whereas paradigm-shifting work in primary prevention of peanut allergy has resulted in significant modifications in the approach to early food introduction in infants and toddlers. Innovative investigation of food allergy epidemiology, systems biology, effect, and management has provided important insights. Although active therapeutic approaches to food allergy remain experimental, progress toward licensed therapies has been substantial. Mechanistic understanding of the immunologic processes underlying food allergy and immunotherapy will inform the future design of therapeutic approaches targeting the food-induced allergic response. Global strategies to mitigate the substantial medical, economic, and psychosocial burden of food allergy in affected subjects and families will require engagement of stakeholders across multiple sectors in research, health care, public health, government, educational institutions, and industry. However, the relationship between the well-informed allergy care provider and the patient and family remains fundamental for optimizing the care of the patient with food allergy.

Keywords: Food allergy; IgE-mediated food allergy; diagnosis; early intervention; epicutaneous immunotherapy; evidence-based guidelines; management; oral food challenge; oral immunotherapy; prevalence; prevention; primary prevention; specific IgE; sublingual immunotherapy.

Publication types

  • Review

MeSH terms

  • Allergy and Immunology / trends*
  • Desensitization, Immunologic / methods
  • Desensitization, Immunologic / trends
  • Food Hypersensitivity* / diagnosis
  • Food Hypersensitivity* / immunology
  • Food Hypersensitivity* / therapy
  • Humans