Generic placeholder image

Current Pediatric Reviews

Editor-in-Chief

ISSN (Print): 1573-3963
ISSN (Online): 1875-6336

Review Article

Advances in Management of Food Allergy in Children

Author(s): Fernanda Chiera*, Lucia Caminiti, Giuseppe Crisafulli and Giovanni Battista Pajno

Volume 16, Issue 2, 2020

Page: [123 - 128] Pages: 6

DOI: 10.2174/1573396316666191227122917

Price: $65

Abstract

Food allergy is a potentially life-threatening medical condition and a significant public health concern worldwide. The current management consists of strict avoidance of the culprit food and treating any adverse reactions from unintended food ingestion. The increasing prevalence of food allergy encouraged research and clinical trials in the field of specific allergen immunotherapy (AIT) which represents an appealing approach, especially in pediatric age. AIT consists of the gradual administration of growing amounts of the offending allergen in order to induce food desensitization, which is an increase in the threshold for reactivity while continuing on regular exposure to the allergen. AIT can be administered through oral, sublingual, epicutaneous, and subcutaneous routes. Reports on oral immunotherapy (OIT) thus far have been more extensive. The desirable goal is to achieve "post desensitization effectiveness", that is the ability to introduce food without reaction even after a period of discontinuation of the offending food. Other therapeutic approaches are being studied alongside immunotherapy such as modified proteins, probiotics, Chinese herbal supplements, biologic therapies, and DNA vaccines.

Keywords: Food allergy, immunotherapy, biologics, modified proteins, DNA vaccine, desensitization.

[1]
Pajno GB, Fernandez-Rivas M, Arasi S, et al. EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy. Allergy 2018; 73(4): 799-815.
[http://dx.doi.org/10.1111/all.13319] [PMID: 29205393]
[2]
Dantzer JA, Wood RA. Next-generation approaches for the treatment of food allergy. Curr Allergy Asthma Rep 2019; 19(1): 5.
[http://dx.doi.org/10.1007/s11882-019-0839-5] [PMID: 30689123]
[3]
Umetsu DT, Rachid R, Schneider LC. Oral immunotherapy and anti-IgE antibody treatment for food allergy. World Allergy Organ J 2015; 8(1): 20.
[http://dx.doi.org/10.1186/s40413-015-0070-3] [PMID: 26185589]
[4]
Huang F, Chawla K, Järvinen KM, Nowak-Węgrzyn A. Anaphylaxis in a New York City pediatric emergency department: triggers, treatments, and outcomes. J Allergy Clin Immunol 2012; 129: 162-8.e1.
[5]
Pajno GB, Bernardini R, Peroni D, et al. Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report. Ital J Pediatr 2017; 43(1): 13.
[http://dx.doi.org/10.1186/s13052-016-0315-y] [PMID: 28257631]
[6]
Savage J, Sicherer S, Wood R. The natural history of food allergy. J Allergy Clin Immunol Pract 2016; 4(2): 196-203.
[http://dx.doi.org/10.1016/j.jaip.2015.11.024] [PMID: 26968958]
[7]
Wood RA. Oral immunotherapy for food allergy. J Investig Allergol Clin Immunol 2017; 27(3): 151-9.
[http://dx.doi.org/10.18176/jiaci.0143] [PMID: 28102823]
[8]
Scurlock AM, Jones SM. Advances in the approach to the patient with food allergy. J Allergy Clin Immunol 2018; 141(6): 2002-14.
[http://dx.doi.org/10.1016/j.jaci.2017.12.1008] [PMID: 29524535]
[9]
Vickery BP, Scurlock AM, Kulis M, et al. Sustained unresponsiveness to peanut in subjects who have completed peanut oral immunotherapy. J Allergy Clin Immunol 2014; 133(2): 468-75.
[http://dx.doi.org/10.1016/j.jaci.2013.11.007] [PMID: 24361082]
[10]
Vickery BP, Vereda A, Casale TB, et al. AR101 Oral Immunotherapy for Peanut Allergy. N Engl J Med 2018; 379(21): 1991-2001.
[http://dx.doi.org/10.1056/NEJMoa1812856] [PMID: 30449234]
[11]
Jones SM, Agbotounou WK, Fleischer DM, et al. Safety of epicutaneous immunotherapy for the treatment of peanut allergy: A phase 1 study using the Viaskin patch. J Allergy Clin Immunol 2016; 137(4): 1258-1261.e10.
[http://dx.doi.org/10.1016/j.jaci.2016.01.008] [PMID: 26920463]
[12]
Jones SM, Sicherer SH, Burks AW, et al. Epicutaneous immunotherapy for the treatment of peanut allergy in children and young adults. J Allergy Clin Immunol 2017; 139(4): 1242-1252.e9.
[http://dx.doi.org/10.1016/j.jaci.2016.08.017] [PMID: 28091362]
[13]
Sampson HA, Shreffler WG, Yang WH, et al. Effect of varying doses of epicutaneous immunotherapy vs placebo on reaction to peanut protein exposure among patients with peanut sensitivity: a randomized clinical trial. JAMA 2017; 318(18): 1798-809.
[http://dx.doi.org/10.1001/jama.2017.16591] [PMID: 29136445]
[14]
Narisety SD, Frischmeyer-Guerrerio PA, Keet CA, et al. A randomized, double-blind, placebo-controlled pilot study of sublingual versus oral immunotherapy for the treatment of peanut allergy. J Allergy Clin Immunol 2015; 135(5): 1275-82.e1. 6
[15]
Keet CA, Frischmeyer-Guerrerio PA, Thyagarajan A, et al. The safety and efficacy of sublingual and oral immunotherapy for milk allergy. J Allergy Clin Immunol 2012; 129(2): 448-55. 455.e1-.
[16]
Enrique E, Pineda F, Malek T, et al. Sublingual immunotherapy for hazelnut food allergy: a randomized, double-blind, placebo-controlled study with a standardized hazelnut extract. J Allergy Clin Immunol 2005; 116(5): 1073-9.
[http://dx.doi.org/10.1016/j.jaci.2005.08.027] [PMID: 16275379]
[17]
Kinaciyan T, Nagl B, Faustmann S, et al. Efficacy and safety of 4 months of sublingual immunotherapy with recombinant Mal d 1 and Bet v 1 in patients with birch pollen-related apple allergy. J Allergy Clin Immunol 2018; 141(3): 1002-8.
[http://dx.doi.org/10.1016/j.jaci.2017.07.036] [PMID: 28870463]
[18]
Rodriguez MJ, Wangorsch A, Gomez F, et al. Immunotherapy with native molecule rather than hypoallergenic variant of pru p 3, the major peach allergen, shows beneficial effects in mice. J Immunol Res 2018; 20183479185
[http://dx.doi.org/10.1155/2018/3479185] [PMID: 30009186]
[19]
Bindslev-Jensen C, de Kam P, van Twuijver E, et al. SCIT-treatment with a chemically modified, aluminum hydroxide adsorbed peanut extract (HAL-MPE1) was generally safe and well tolerated and showed immunological changes in peanut allergic patients. J Allergy Clin Immunol 2017; 139(2): AB191.
[http://dx.doi.org/10.1016/j.jaci.2016.12.623]
[20]
Wood RA, Kim JS, Lindblad R, et al. A randomized, double-blind, placebo-controlled study of omalizumab combined with oral immunotherapy for the treatment of cow’s milk allergy. J Allergy Clin Immunol 2016; 137(4): 1103-1110.e11.
[http://dx.doi.org/10.1016/j.jaci.2015.10.005] [PMID: 26581915]
[21]
MacGinnitie AJ, Rachid R, Gragg H, et al. Omalizumab facilitates rapid oral desensitization for peanut allergy. J Allergy Clin Immunol 2017; 139(3): 873-881.e8.
[http://dx.doi.org/10.1016/j.jaci.2016.08.010] [PMID: 27609658]
[22]
Pajno GB, Nadeau KC, Passalacqua G, et al. The evolution of allergen and non-specific immunotherapy: past achievements, current applications and future outlook. Expert Rev Clin Immunol 2015; 11(1): 141-54.
[http://dx.doi.org/10.1586/1744666X.2015.977260] [PMID: 25454510]
[23]
Muto T, Fukuoka A, Kabashima K, et al. The role of basophils and proallergic cytokines, TSLP and IL-33, in cutaneously sensitized food allergy. Int Immunol 2014; 26(10): 539-49.
[http://dx.doi.org/10.1093/intimm/dxu058] [PMID: 24860117]
[24]
Prickett SR, Voskamp AL, Phan T, et al. Ara h 1 CD4+ T cell epitope-based peptides: candidates for a peanut allergy therapeutic. Clin Exp Allergy 2013; 43(6): 684-97.
[http://dx.doi.org/10.1111/cea.12113] [PMID: 23711131]
[25]
Cook QS, Burks AW. Peptide and Recombinant Allergen Vaccines for Food Allergy. Clin Rev Allergy Immunol 2018; 55(2): 162-71.
[http://dx.doi.org/10.1007/s12016-018-8673-4] [PMID: 29368278]
[26]
Srivastava KD, Bardina L, Sampson HA, Li XM. Efficacy and immunological actions of FAHF-2 in a murine model of multiple food allergies. Ann Allergy Asthma Immunol 2012; 108(5): 351-358.e1.
[http://dx.doi.org/10.1016/j.anai.2012.03.008] [PMID: 22541407]
[27]
Wang J, Jones SM, Pongracic JA, et al. Safety, clinical, and immunologic efficacy of a Chinese herbal medicine (Food Allergy Herbal Formula-2) for food allergy. J Allergy Clin Immunol 2015; 136(4): 962-970.e1.
[http://dx.doi.org/10.1016/j.jaci.2015.04.029] [PMID: 26044855]
[28]
Tang ML, Ponsonby AL, Orsini F, et al. Administration of a probiotic with peanut oral immunotherapy: A randomized trial. J Allergy Clin Immunol 2015; 135(3): 737-44.e8.
[http://dx.doi.org/10.1016/j.jaci.2014.11.034] [PMID: 25592987]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy