Food allergy: immune mechanisms, diagnosis and immunotherapy

Abstract

Food allergy is a pathological, potentially deadly, immune reaction triggered by normally innocuous food protein antigens. The prevalence of food allergies is rising and the standard of care is not optimal, consisting of food-allergen avoidance and treatment of allergen-induced systemic reactions with adrenaline. Thus, accurate diagnosis, prevention and treatment are pressing needs, research into which has been catalysed by technological advances that are enabling a mechanistic understanding of food allergy at the cellular and molecular levels. We discuss the diagnosis and treatment of IgE-mediated food allergy in the context of the immune mechanisms associated with healthy tolerance to common foods, the inflammatory response underlying most food allergies, and immunotherapy-induced desensitization. We highlight promising research advances, therapeutic innovations and the challenges that remain.

Histamine-releasing factor enhances food allergy

“…Symptoms of food allergy range from itching, hives, and diarrhea to life-threatening anaphylaxis. Currently, there is no cure for this disease, although allergen-specific immunotherapy can successfully treat some patients (3)(4)(5)(6). Basic studies have provided insights into the pathophysiology using various animal models (7,8).…”

“…Histamine-releasing factor enhances food allergy Tomoaki Ando, 1,2 Jun-ichi Kashiwakura, 1 Naoka Itoh-Nagato, 3 Hirotaka Yamashita, 4 Minato Baba, 5 Yu Kawakami,5 Shih Han Tsai,6,7 Naoki Inagaki, 4 Kiyoshi Takeda, 6,7 Tsutomu Iwata, 8 Naoki Shimojo, 9 Takao Fujisawa, 10 Mizuho Nagao, transcriptase PCR (qRT-PCR) analyses of jejunum ( Figure 1I and data not shown) showed increased Th2 cytokine mRNAs (Il4 and Il13) in diarrheal mice, which was repressed in inhibitorpretreated mice. In contrast, levels of total IgE, IgG1, IgG2a, or HRF-reactive IgE and IgG were not reduced by HRF inhibitor ( Figure 1, C and E, and data not shown).…”

Comparison between digital and optical microscopy: Analysis in a mouse gut inflammation model

“…The primary strategies used to diagnose a food allergy are evaluating clinical history and performing physical examination, whereas the definitive method is to submit the patient to an oral challenge with the suspected food and assess the allergic reactions at an organ level (20,21). For researchers, the state of the organs is particularly interesting to enable investigation of the pathological mechanisms of the disease and the development of novel treatment methods (21,22).…”

Allergic Rhinitis in Relation to Food Allergies: Pointers to future research

“…[10][11][12] On the other hand, non-IgEmediated food allergies, such as food protein-induced enterocolitis syndrome, food protein-induced proctocolitis and food protein enteropathy, are less common and are usually due to a chronic inflammation of the gastrointestinal tract; such conditions are mediated through allergen-specific T cells or eosinophils and primarily affect the gastrointestinal rather than respiratory tract. 13 Allergic rhinitis is more frequently associated with a secondary rather than a primary food allergy.…”