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PEDIATRICS Vol. 111 No. 6 June 2003, pp. 1672-1680

Future Approaches to Food Allergy

Anna Nowak-Wegrzyn, MD

From the Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, New York

Food allergy affects ~2% of the general US population, and its prevalence seems to be increasing. Despite the potential for a fatal outcome, no definitive therapies are available for food allergy. This article reviews novel approaches for the diagnosis and treatment of food allergy. Improved diagnostic methods include more precise in vitro and in vivo tests for immunoglobulin E-mediated food allergies, in vitro assays for predicting development of oral tolerance, and novel noninvasive tests for cell-mediated food allergies such as patch testing, cytokine assays, and detection of eosinophil activation markers. Several promising novel immunomodulatory approaches to food allergy are discussed, including monoclonal anti-immunoglobulin E; probiotics; traditional Chinese medicine; and immunotherapy with modified food proteins, peptides, bacterial adjuvants, and immunostimulatory sequences.

Key Words: food allergy • diagnosis • immunomodulatory therapy • probiotics • anti-IgE antibodies • immunotherapy • traditional Chinese medicine • patch testing

Abbreviations: IgE, immunoglobulin E • IL, interleukin • IFN-{gamma}, {gamma}-interferon • TNF, tumor necrosis factor • TGF-ß, tumor growth factor-ß • TCM, traditional Chinese medicine • FAHF-1, food allergy herbal formula-1 • HKL, heat-killed Listeria • ISS-ODN, oligodeoxynucleotide immunostimulatory sequences

Received for publication Sep 11, 2002; Accepted Oct 30, 2002.


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