State of the Art on Food Allergy Immunotherapy

Abstract

Food allergy is increasing in prevalence in westernized countries, leading to significant morbidity including nutritional deficiencies and the potential for fatal anaphylaxis during accidental exposure to the allergen. The current treatment remains strict avoidance, although the disease is not cured. Allergen specific immunotherapy for food allergy is currently being actively evaluated, but is still experimental. Nevertheless, it is the only disease-modifying therapy for IgE-mediated food allergy and appears to be a promising method of desensitization and tolerance achievement. Despite the success of different protocols studied in clinical trials (oral, sublingual and epicutaneous immunotherapy), the main drawback is the appearance of adverse reactions, which impacts in the patient adherence to the treatment. The mechanisms underlying successful food desensitization are also unclear, in part because there is no standard immunotherapy protocol and different mechanisms have been proposed. The treatment variations currently being investigated increases the likelihood of finding novel or modified therapies for food allergy. In this regard, mouse models of experimental allergy constitute a valuable biological tool to elucidate and understand these mechanisms, and to evaluate novel therapeutic strategies.