Can food allergy be cured? What are the future prospects?

Abstract

Food allergies have become a significant heath burden as prevalence continues to rise, affecting 6%‐13% of the global population. In the absence of drugs approved by regulatory agencies, the current standard of care remains avoidance of allergenic foods and management of acute allergic reactions with antihistamines and epinephrine autoinjectors. Allergen immunotherapy has been shown to increase the threshold of reactivity in the majority of food‐allergic individuals. However, challenges include long treatment periods, high rates of adverse reactions, and lack of permanence of desensitization and established protocols. To address these limitations, adjunctive allergen‐specific immunotherapy, vaccines, and non–allergen‐specific therapies (eg, monoclonal antibodies) are being explored. The future of food allergy treatment is promising with a number of clinical trials in progress. Currently, although desensitization can be achieved for the majority of individuals with food allergy through immunotherapy, continued ingestion of allergen is needed for most individuals to maintain desensitization. Further understanding of the mechanisms of food allergy and identification of biomarkers to distinguish between temporary and permanent resolution of allergies is needed before a cure, where reactivity to the allergen is permanently lost enabling the individual to consume the allergen in any amount at any time, can be envisioned.

Vaccines and allergic reactions: The past, the current COVID‐19 pandemic, and future perspectives

“…Individuals with IgE‐mediated allergic reactions first undergo an initial sensitization phase during which allergen‐specific IgE antibodies bind to high‐affinity FcεRI receptors on mast cells and basophils. Subsequent allergen exposure can cross‐link the cell‐bound IgE antibodies and triggers degranulation of mast cells and/or basophils, with subsequent release of histamine and other inflammatory chemical mediators (cytokines, interleukins, leukotrienes, and prostaglandins) into the surrounding tissue causing several systemic effects, such as vasodilation, mucous secretion, tissue eosinophilic infiltration, and airway smooth muscle contraction 56 …”

Oral Immunotherapy for Food-Allergic Children: A Pro-Con Debate

“…OIT effectiveness is normally assessed using two possible outcomes: desensitization or SU ( 32 , 33 ). As mentioned above, desensitization is the patient’s ability to increase the minimal amount of allergen required to elicit an allergic reaction; to be maintained, it requires daily allergen exposure ( 34 ).…”

B regulatory cells in allergy

“…Food allergy is an adverse immune reaction toward naturally processed food proteins, which can be classified as IgE‐mediated, non–IgE‐mediated, or mixed‐type 76 . Food allergy symptoms include oropharyngeal pruritus, nausea, urticaria, and angioedema can sometimes involve respiratory symptoms and can be life‐threatening due to systemic anaphylaxis 145 . IL‐10‐secreting CD5 + Bregs and TGF‐β–producing Breg cells have been well characterized in non–IgE‐mediated food allergy and atopic dermatitis 146 .…”