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Review
. 2020 Jan;91(1):e12824.
doi: 10.1111/sji.12824. Epub 2019 Nov 24.

Food allergy-From food avoidance to active treatment

Célia Costa  1 , Alice Coimbra  2 , Artur Vítor  3 , Rita Aguiar  1 , Ana Luísa Ferreira  4 , Ana Todo-Bom  5   6
Affiliations
Free article
Review

Food allergy-From food avoidance to active treatment

Célia Costa et al. Scand J Immunol. 2020 Jan.
Free article

Abstract

The prevalence of food allergy (FA) has increased too rapidly, possibly due to environmental factors. The guidelines recommend strict allergen avoidance, but FA is still the main cause of anaphylaxis in all age groups. Immunotherapy is the only treatment able to change the course of allergic disease, and oral immunotherapy (OIT) is the more effective route in FA. However, it carries the risk of adverse reactions, including anaphylaxis. To improve OIT safety, adjuvant therapy with the immunoglobulin E (IgE) monoclonal antibody omalizumab has been extensively used. Results suggest particular benefit in patients with high risk of fatal anaphylaxis. An alternative approach is to use omalizumab instead of OIT to prevent severe allergic reactions upon accidental exposure. This paper reviews current evidence regarding IgE-mediated FA, focusing on natural tolerance and food sensitization acquisition, and on avoidance measures and their limitations.

Keywords: IgE-mediated food allergies; avoidance measures; food sensitization.

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References

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