Food allergy: Is strict avoidance the only answer?
Article first published online: 15 SEP 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Pediatric Allergy and Immunology
Volume 20, Issue 5, pages 415–422, August 2009
How to Cite
Allen, C. W., Campbell, D. E. and Kemp, A. S. (2009), Food allergy: Is strict avoidance the only answer?. Pediatric Allergy and Immunology, 20: 415–422. doi: 10.1111/j.1399-3038.2008.00811.x
- Issue published online: 22 JUL 2009
- Article first published online: 15 SEP 2008
- Accepted 18 January 2008
- food hypersensitivity;
- immunological tolerance;
It is an immunological paradigm that avoidance of food allergen may reduce the risk or prevent immunological reactions and conversely that a greater exposure increases the magnitude of the immune response. Consequently, food allergen avoidance has been recommended to reduce the risk of sensitization in infants and to prevent clinical reactions in children with positive skin prick tests (SPT). In the latter setting, it is hoped that avoidance may either promote or at least not retard the development of tolerance. Animal studies, however, have demonstrated that tolerance to food allergens may be induced by either large (high zone tolerance) or small (low zone tolerance) doses, whereas doses in between may actually stimulate immune responses. In this review, we discuss whether strict allergen avoidance is always the most appropriate strategy for preventing or managing IgE-mediated food allergy.