Future therapies for food allergies

• Published in: Journal of allergy and clinical immunology Vol. 127; no. 3; pp. 558 - 573
• Main Authors: Nowak-Węgrzyn, Anna, Sampson, Hugh A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2011; Elsevier Limited
• Subjects: Accreditation; Advisors; allergens; Allergies; Allergy and Immunology; anaphylaxis; animal models; Animals; anti-IgE; anti-IgE therapy; antibodies; anti–IL-5 therapy; Arachis hypogaea; children; Clinical trials; Clinical Trials as Topic; Cytokines; desensitization; diet; Disease; egg allergy; Egg Hypersensitivity - therapy; eggs; epicutaneous immunotherapy; Escherichia coli; Food; Food allergies; Food allergy; Food Hypersensitivity - immunology; Food Hypersensitivity - therapy; foods; hens; Hot Temperature; Humans; immune response; Immunotherapy; Immunotherapy - trends; Medical research; Milk; Milk - adverse effects; Milk - immunology; milk allergy; oral immunotherapy; patients; peanut allergy; peanuts; Physicians; Probiotics; recombinant proteins; Shellfish; Studies; sublingual immunotherapy; Food allergy; epicutaneous immunotherapy; oral immunotherapy; anti-IgE therapy; anti–IL-5 therapy; PFAS; peanut allergy; anti-IgE; Man51-BSA; FAHF; FoxP3; SIGNR-1; SLIT; HKE; HKLM; ISS; desensitization; milk allergy; pDNA; EPIT; TLR9; EoE; sublingual immunotherapy; egg allergy; OIT; DBPCFC; probiotics; TCM; Pollen-food allergy syndrome; Man 51-BSA; Immunostimulatory sequence; Forkhead box protein 3; Heat-killed Escherichia coli; C-type lectin receptor, also called CD209b; Plasmid DNA; Double-blind, placebo-controlled food challenge; Heat-killed Listeria moncytogenes; Eosinophilic esophagitis; Traditional Chinese medicine; Mannoside-conjugated BSA; Toll-like receptor 9; Food Allergy Herbal Formula
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2010.12.1098

Food allergy is an increasingly prevalent problem in westernized countries, and there is an unmet medical need for an effective form of therapy. A number of therapeutic strategies are under investigation targeting foods that most frequently provoke severe IgE-mediated anaphylactic reactions (peanut, tree nuts, and shellfish) or are most common in children, such as cow's milk and hen's egg. Approaches being pursued are both food allergen specific and nonspecific. Allergen-specific approaches include oral, sublingual, and epicutaneous immunotherapy (desensitization) with native food allergens and mutated recombinant proteins, which have decreased IgE-binding activity, coadministered within heat-killed Escherichia coli to generate maximum immune response. Diets containing extensively heated (baked) milk and egg represent an alternative approach to food oral immunotherapy and are already changing the paradigm of strict dietary avoidance for patients with food allergy. Nonspecific approaches include monoclonal anti-IgE antibodies, which might increase the threshold dose for food allergen in patients with food allergy, and a Chinese herbal formulation, which prevented peanut-induced anaphylaxis in a murine model and is currently being investigated in clinical trials. The variety of strategies for treating food allergy increases the likelihood of success and gives hope that accomplishing an effective therapy for food allergy is within reach.