Update on food allergy

Abstract

Food allergy (FA) can be classified into IgE-and non-IgE-mediated depending on the involvement of IgE in its pathogenesis. In this review, we are focusing on IgE-mediated food allergy. FA affects about 8% of children in the Western countries and seems to be rising in other parts of the world such as in Vietnam and South Africa, and other parts of Asia and Africa, particularly in urban rather than rural areas. [1][2][3][4] The prevalence of FA has increased over the recent decades, as has the number of hospitalizations for food-induced anaphylaxis, following what seems to be the 'second wave of the allergy epidemic' after the rise in the prevalence of asthma and respiratory allergy in previous decades. [5][6][7] Pouessel et al 8 have shown that foods caused 37% of cases of ICU admissions for anaphylaxis and 79% of recurrent anaphylaxis. Self-reported FA is even more common with an often underappreciated impact. 1 Gupta et al 1 report that about 40% of food allergic children report multiple food allergies, often severe food allergies, and carry an adrenaline auto-injector. In Western countries, such as the USA and the UK, FA affects disproportionally children from ethnic minorities, such as children of Afro-Caribbean descent. 1,9,10 Whether this has to do with genetic predisposition in face of environmental factors related to the modern lifestyle

The Risk of Undeclared Allergens on Food Labels for Pediatric Patients in the European Union

“…As there is no curative treatment for food allergies, and allergen avoidance is the mainstay of management, the presence of undeclared allergens in food implies a significantly dangerous risk for allergic patients. The avoidance of food allergens is onerous for patients and families and often fails, with 10% of patients on average experiencing at least one allergic reaction per year [16]. In their study, Fleischer et al established that 87.4% of allergic reactions to foods in preschool-aged children were mainly caused by accidental exposure.…”

Comments on asthma development and prognosis, and diagnosis of cow's milk allergy

“…19 Nevertheless, when allergy is suspected, tools such as the molecular-based IgE diagnosis, and in dubious cases an oral food challenge, might be of best value. [20][21][22][23] Besides the selected articles, you will find original articles as well as letters on various other issues. The editorial team of PAI hopes that you will enjoy reading them.…”

“…Symptom scores might be of great help to the primary care physician for the first screening of patients, as the perception of cow's milk allergy is largely present in the population 19 . Nevertheless, when allergy is suspected, tools such as the molecular‐based IgE diagnosis, and in dubious cases an oral food challenge, might be of best value 20‐23 …”

Interleukin-18 Receptor α Modulates the T Cell Response in Food Allergy

“… 4 Thus, a better understanding of the underlying immune mechanisms and signaling pathways of food allergy is warranted to develop more effective and safe therapies that provide long-term protection in patients of various ages and with different responsiveness. 5 6 7 Typically, when food allergens penetrate the epithelial barrier, naïve T cells differentiate into CD4 + T-helper type 2 (Th2) cells, initiating the transcription of several cytokines, including interleukin (IL)-4, IL-5, and IL-13. Th2 cells promote antigen-specific IgE development through class-switching via B cells, ultimately inducing Th2 cell-mediated effector responses through mast cells during food allergy.…”