Prevention of food allergy

Abstract

The past few decades have witnessed an increase in the prevalence of IgE-mediated food allergy (FA). For prevention strategies to be effective, we need to understand the causative factors underpinning this rise. Genetic factors are clearly important in the development of FA, but given the dramatic increase in prevalence over a short period of human evolution, it is unlikely that FA arises through germline genetic changes alone. A plausible hypothesis is that 1 or more environmental exposures, or lack thereof, induce epigenetic changes that result in interruption of the default immunologic state of tolerance. Strategies for the prevention of FA might include primary prevention, which seeks to prevent the onset of IgE sensitization; secondary prevention, which seeks to interrupt the development of FA in IgE-sensitized children; and tertiary prevention, which seeks to reduce the expression of end-organ allergic disease in children with established FA. This review emphasizes the prevention of IgE-mediated FA through dietary manipulation, among other strategies; in particular, we focus on recent interventional studies in this field.

Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–Sponsored Expert Panel

“…Among the 98 participants with positive peanut SPT responses at entry, 35.3% of the avoidance group and 10.6% of the consumption group had peanut allergy at 60 months of age (P = .004; a 24.7% absolute risk reduction and a 70% relative risk reduction in the prevalence of peanut allergy, resulting in a number needed to treat of 4). The LEAP-on study [24] demonstrated that the benefits achieved in the LEAP trial persisted when LEAP trial peanut consumers subsequently avoided peanut for 1 year from 60 to 72 months of age. This indicates that the oral tolerance achieved in the LEAP trial was durable.…”

The unmet provision of allergy services in Hong Kong impairs capability for allergy prevention – implications for the Asia Pacific region

“…20 The inclusion of an aggressive eczema treatment strategy distinguished the PETIT study from the other clinical trials and thus this was a likely explanation for the difference in results. 23 An earlier randomised controlled trial of 118 Japanese drive forward discovery science and clinical practice. This will inevitably require dedicated investments of resources but the payback for implementing a successful strategy could be substantial public health gains.…”

A selective and sensitive nanosensor for fluorescent detection of specific IgEs to purified allergens in human serum

“…The prevalence of food allergy reactions, which range in severity from relatively mild features to life-threatening anaphylaxis, has been estimated as affecting up to 7% of children and 6% of adults [1][2][3][4][5][6] and is currently considered as a global public health problem. 7,8 The clinical diagnosis of food allergy primarily involves skin testing 9,10 and blood (serum) analysis.…”