Food Allergy Diagnosis and Therapy: Where are we Now?

Abstract

Food allergy is a growing worldwide epidemic that adversely effects up to 10% of the population. Causes and risk factors remain unclear and diagnostic methods are imprecise. There is currently no accepted treatment for food allergy. Therefore, there is an imminent need for greater understanding of food allergies, revised diagnostics and development of safe, effective therapies. Oral immunotherapy provides a particularly promising avenue, but is still highly experimental and not ready for clinical use.

Allergic reactions: key aspects and new perspectives

“…6. Inmunoterapia moduladora, tanto específica como no específica, que a partir de la administración continua y progresiva por largos períodos de tiempo (3años -5 años) de un compuesto, se busca la producción de Ig G4 específicas contra el (los) alérgeno (s), que no se unen a los mastocitos y de LT reguladores sobre la respuesta inmune LTh1 y LTh2 (79,80). Se están generando nuevas estrategias como el uso de alérgenos recombinantes, péptidos contenidos en epítopes de células B y T, vacunación con DNA e inmunoterapia sublingual (que ha demostrado su eficacia y seguridad, pero no ha sido aprobado su utilización por parte de la administración de alimentos y medicamentos -FDA-) (81,82).…”

The role of epigenetic mediation and the future of food allergy research

“…Thus, there is still much that remains unknown in regards to the causes and underlying biological mechanisms. Currently, FA is understood to be the dysregulation of normal immune tolerance where tolerance is the mechanism in which the adaptive immune system does not elicit an inflammatory response to self-antigens or innocuous antigens like food proteins [3,8,9]. The mechanisms of immune tolerance remain largely unknown, but it is believed that several antigen-presenting immune cells including dendritic cells [10], macrophages [11], and T regulatory cells (Treg) [12] mediate the suppression of an inappropriate immune response.…”

“…However, there are several specific and nonspecific immunotherapies for FA currently in experimental stages of investigation that offer great promise and hope in desensitizing patients [58]. Several of these approaches have demonstrated some success in desensitizing patients from egg [59,60], milk [61][62][63][64], peanuts [65,66], and from multiple allergens [67].…”

“…Several of these approaches have demonstrated some success in desensitizing patients from egg [59,60], milk [61][62][63][64], peanuts [65,66], and from multiple allergens [67]. Of these experimental therapies including sublingual immunotherapy, oral immunotherapy (OIT), anti-IgE, epicutaneous immunotherapy, intralymphatic immunotherapy, and peptide immunotherapy, OIT is currently the most well-studied and potentially the most promising in achieving desensitization and maybe even tolerance in FA patients [9]. Desensitization differs from tolerance in that patients who are desensitized from allergens have an increased reactivity threshold that is dependent upon the daily, uninterrupted dosages of allergens.…”

The Potential of Anti-IgE in Food Allergy Therapy

“…The response is recorded in terms of diameter of wheal, which reflects food-allergen-induced mast cell degranulation, and thus demonstrates prior sensitization. Allergen-specific IgE levels are estimated through commercially available sandwich assays [6,7]. Although helpful in identifying foods that can potentially provoke IgE-mediated allergic reactions, skin prick test or allergen-specific IgE alone, or in combination, are not recommended to confirm diagnosis of food allergy [1].…”