The future of food allergy: Challenging existing paradigms of clinical practice

Abstract

The field of food allergy has seen tremendous change over the past 5–10 years with seminal studies redefining our approach to prevention and management and novel testing modalities in the horizon. Early introduction of allergenic foods is now recommended, challenging the previous paradigm of restrictive avoidance. The management of food allergy has shifted from a passive avoidance approach to active interventions that aim to provide protection from accidental exposures, decrease allergic reaction severity and improve the quality of life of food‐allergic patients and their families. Additionally, novel diagnostic tools are making their way into clinical practice with the goal to reduce the need for food challenges and assist physicians in the—often complex—diagnostic process. With all the new developments and available choices for diagnosis, prevention and therapy, shared decision‐making has become a key part of medical consultation, enabling patients to make the right choice for them, based on their values and preferences. Communication with patients has also become more complex over time, as patients are seeking advice online and through social media, but the information found online may be outdated, incorrect, or lacking in context. The role of the allergist has evolved to embrace all the above exciting developments and provide patients with the optimal care that fits their needs. In this review, we discuss recent developments as well as the evolution of the field of food allergy in the next decade.

The Prevalence of Self-Reported Systemic Allergic Reaction to Hymenoptera Venom in Beekeepers Worldwide: A Systematic Literature Review and Meta-Analysis

“…This selective participation could have led to an overestimation of the overall lifetime prevalence of self-reported SAR to bee venom, particularly for mild grades (grade I: 233 out of 852 (27.3%); grade II: 111 out of 852 (13.0%)) ( 20 ). The phenomenon of overestimation in both parental and self-reported data is a well-documented issue in assessing the prevalence of food allergies ( 29 ), and has also been reported in the context of HVA. Studies conducted in Poland revealed an overestimation in the prevalence of LLR and mild SAR when comparing self-reported estimates to those objectively assessed by a physician ( 30 ).…”

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“…There is an additional challenge in some patients with severe allergies not qualifying for OFCs due to the substantial risk of severe allergic reactions. Therefore, a critical aspect of the current landscape is the need to explore alternative diagnostic methods that can alleviate these challenges 20–22 …”

“…Therefore, a critical aspect of the current landscape is the need to explore alternative diagnostic methods that can alleviate these challenges. [20][21][22] In this context, researchers have turned to BATs and MATs as potential solutions. These in vitro tests, in theory, offer numerous advantages over OFCs.…”

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