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Review
. 2023 Jul;131(1):29-36.
doi: 10.1016/j.anai.2023.04.023. Epub 2023 Apr 25.

Treatment of food allergy: Oral immunotherapy, biologics, and beyond

Sayantani B Sindher  1 , Claire Hillier  2 , Brent Anderson  2 , Andrew Long  2 , R Sharon Chinthrajah  2
Affiliations
Review

Treatment of food allergy: Oral immunotherapy, biologics, and beyond

Sayantani B Sindher et al. Ann Allergy Asthma Immunol. 2023 Jul.

Abstract

The prevalence of food allergy (FA) has been increasing globally and comes with a heavy burden not just economically, but also on quality of life. Although oral immunotherapy (OIT) is effective at inducing desensitization to food allergens, it has several limitations that weaken its success. Limitations include a long duration of build-up, especially when used for multiple allergens, and a high rate of reported adverse events. Furthermore, OIT may not be effective in all patients. Efforts are underway to identify additional treatment options, either as monotherapy or in combination, to treat FA or enhance the safety and efficacy of OIT. Biologics such as omalizumab and dupilumab, which already have US Food and Drug Administration approval for other atopic conditions have been the most studied, but additional biologics and novel strategies are emerging. In this review, we discuss therapeutic strategies including immunoglobulin E inhibitors, immunoglobulin E disruptors, interleukin-4 and interleukin-13 inhibitors, antialarmins, JAK1 and BTK inhibitors, and nanoparticles, and the data surrounding their application in FA and highlighting their potential.

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Conflict of interest statement

Conflict of Interest:

Dr. Long reports consultant fees from COUR Pharmaceuticals. Dr. Chinthrajah reports grants from NIAID, CoFAR, Aimmune, DBV Technologies, Astellas, Regeneron, Stanford Maternal and Child Health Research Institute (MCHRI), and FARE. She is an Advisory Board Member at Alladapt Therapeutics, Novartis, Genentech, Sanofi, Allergenis, and Intrommune Therapeutics. Dr. Sindher reports grants from NIH, Regeneron, DBV Technologies, Aimmune, Novartis, CoFAR, and FARE. She is an Advisory member at Genentech and DBV Technologies. All other authors indicate no conflicts of interest.

Figures

Figure 1.
Figure 1.
FA pathways targeted by therapeutics. Common pathways targeted by therapeutic strategies in FA.
Figure 2.
Figure 2.
Strengths and limitations of therapeutic strategies in FA.
See this image and copyright information in PMC

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