Feast for thought: A comprehensive review of food allergy 2021-2023

Abstract

A review of the latest publications in food allergy over the past couple of years confirmed that food allergy is a major public health concern, affecting about 8% of children and 10% of adults in developed countries. The prevalence of food allergy varies around the world, with the increase being driven mainly by environmental factors, possibly together with genetic susceptibility to environmental changes. A precise diagnosis of food allergy is extremely important. Both new tests (eg, the basophil activation test) and improved optimization of information provided by existing tests (eg, the skin prick test and measurement of specific IgE level) can contribute to improving the accuracy and patients' comfort of food allergy diagnosis. Understanding the underlying immune mechanisms is fundamental to designing allergen-specific treatments that can be safe and effective in the long term. New discoveries of the immune response to food allergens, including T-cell and B-cell responses, have emerged. Novel therapeutic approaches are being trialed at various stages of development as attempts to allow for more active intervention to treat food allergy. Prevention is key to reducing the increase in prevalence. Early introduction of allergenic foods seems to be the most effective intervention, but others are being studied, and will, it is hoped, lead to modification of the epidemiologic trajectory of food allergy over time.

Keywords: Food allergy; IgE; basophil activation test; diagnosis; immunotherapy; omalizumab; severity; skin prick test.

Fig 1

Prevalence of FA around the world according to clinical diagnosis of FA (represented in bold) and self-reported FA (indicated between parentheses). Clinical diagnosis of FA is defined as physician-confirmed FA based on suggestive history and allergen-specific IgE evidenced by skin prick testing and/or measurement of specific IgE, or based on challenge-proven FA. Different age groups are represented in different colors (adults in blue;children inred; and all age groups, including adolescents,in green).

Fig 2

Highlights on the topics of the novel publications about mechanisms of FA and tolerance mentioned in the text.