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Food allergy: recent advances in pathophysiology and treatment.

Abstract

Food allergies, defined as an adverse immune response to food proteins, affect as many as 6% of young children and 3%-4% of adults in westernized countries, and their prevalence appears to be rising. In addition to well-recognized acute allergic reactions and anaphylaxis triggered by IgE antibody-mediated immune responses to food proteins, there is an increasing recognition of cell-mediated disorders such as eosinophilic gastroenteropathies and food protein-induced enterocolitis syndrome. We are gaining an increasing understanding of the pathophysiology of food allergic disorders and are beginning to comprehend how these result from a failure to establish or maintain normal oral tolerance. Many food allergens have been characterized at a molecular level, and this knowledge, combined with an increasing appreciation of the nature of humoral and cellular immune responses resulting in allergy or tolerance, is leading to novel therapeutic approaches. Currently, management of food allergies consists of educating the patient to avoid ingesting the responsible allergen and initiating therapy if ingestion occurs. However, numerous strategies for definitive treatment are being studied, including sublingual/oral immunotherapy, injection of anti-IgE antibodies, cytokine/anticytokine therapies, Chinese herbal therapies, and novel immunotherapies utilizing engineered proteins and strategic immunomodulators.

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  • Authors+Show Affiliations

    ,

    The Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, New York 10029-6574, USA. scott.sicherer@mssm.edu

    Source

    Annual review of medicine 60: 2009 pg 261-77

    MeSH

    Food Hypersensitivity
    Humans

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    18729729

    Citation

    Sicherer, Scott H., and Hugh A. Sampson. "Food Allergy: Recent Advances in Pathophysiology and Treatment." Annual Review of Medicine, vol. 60, 2009, pp. 261-77.
    Sicherer SH, Sampson HA. Food allergy: recent advances in pathophysiology and treatment. Annu Rev Med. 2009;60:261-77.
    Sicherer, S. H., & Sampson, H. A. (2009). Food allergy: recent advances in pathophysiology and treatment. Annual Review of Medicine, 60, pp. 261-77. doi:10.1146/annurev.med.60.042407.205711.
    Sicherer SH, Sampson HA. Food Allergy: Recent Advances in Pathophysiology and Treatment. Annu Rev Med. 2009;60:261-77. PubMed PMID: 18729729.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Food allergy: recent advances in pathophysiology and treatment. AU - Sicherer,Scott H, AU - Sampson,Hugh A, PY - 2008/8/30/pubmed PY - 2009/9/10/medline PY - 2008/8/30/entrez SP - 261 EP - 77 JF - Annual review of medicine JO - Annu. Rev. Med. VL - 60 N2 - Food allergies, defined as an adverse immune response to food proteins, affect as many as 6% of young children and 3%-4% of adults in westernized countries, and their prevalence appears to be rising. In addition to well-recognized acute allergic reactions and anaphylaxis triggered by IgE antibody-mediated immune responses to food proteins, there is an increasing recognition of cell-mediated disorders such as eosinophilic gastroenteropathies and food protein-induced enterocolitis syndrome. We are gaining an increasing understanding of the pathophysiology of food allergic disorders and are beginning to comprehend how these result from a failure to establish or maintain normal oral tolerance. Many food allergens have been characterized at a molecular level, and this knowledge, combined with an increasing appreciation of the nature of humoral and cellular immune responses resulting in allergy or tolerance, is leading to novel therapeutic approaches. Currently, management of food allergies consists of educating the patient to avoid ingesting the responsible allergen and initiating therapy if ingestion occurs. However, numerous strategies for definitive treatment are being studied, including sublingual/oral immunotherapy, injection of anti-IgE antibodies, cytokine/anticytokine therapies, Chinese herbal therapies, and novel immunotherapies utilizing engineered proteins and strategic immunomodulators. SN - 1545-326X UR - https://www.unboundmedicine.com/medline/citation/18729729/Food_allergy:_recent_advances_in_pathophysiology_and_treatment_ L2 - http://arjournals.annualreviews.org/doi/full/10.1146/annurev.med.60.042407.205711?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -