New visions for food allergy: An iPAC summary and future trends

Authors


  • Conflict of interest: P. A. E. has received funding from Phadia and conference honoraria from Phadia, Nestlé and Mead-Johnson; H. A. S. has acted as a paid consultant to Allertein Therapeutics, LLP, E. S. is employed by Phadia AB, Uppsala, Sweden; A.W. B. is an employer of Duke University Medical Center, he is a consultant for ActoGeniX NV, Novartis, McNeil Nutritionals and Mead Johnson, he is on the Advisory Board for Dannon Co. Probiotics, he is a minority stockholder in Allertein and MastCell, Inc., he is on the expert panel for Nutricia, on the speakerós bureau for EpiPen/Dey, L.P. and in on the Data Monitoring Committee for Genentech. Dr Burks has also received grants from the National Institute of Health, Food Allergy and Anaphylaxis Neywork, Gerber and Mead Johnson. He has also had volunteer positions with FAAN, ACAAI, NIH HAI and JACI; G. L. has not declared any conflict of interest.

Philippe A. Eigenmann, University Children's Hospital of Geneva, 6 rue Willy-Donze, 1211 Geneva 14, Switzerland
Tel.: +41-22-382 4531
Fax: +41-22-322 4779
E-mail: Philippe.Eigenmann@hcuge.ch

Abstract

The spectrum of food allergy consists of a variety of different clinical pictures including immunoglobulin (Ig)E, and non-IgE food allergy as well as mixed, IgE and non-IgE disorders. In addition, eosinophilic diseases of the gastrointestinal (GI) tract with occasional IgE-type sensitization are increasingly recognized. As a consequence, the clinical picture of food allergy is pleomorphic and can range from chronic GI symptoms to severe anaphylaxis. The diagnosis of food allergy is mostly hampered by the lack of reliable in vitro tests for non-IgE-mediated diseases, and in most cases relies on a reoccurrence of symptoms upon re-exposure to the antigen; in general during a standardized food challenge. Currently, there is no safe and efficient treatment for food allergy and the treatment relies on avoidance diets. Priorities for research have been identified by iPAC (international Pediatric Allergy and Asthma Consortium) and outlined in this review. They include studies to better identify the pathogenesis of food allergy, including genetic aspects; studies to develop diagnostic and follow-up tests; studies for standardization of food challenges; as well as studies addressing a safe and efficient treatment of food allergy.

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