Pathogenesis of Food Allergy in the Pediatric Patient

In the US and other developed countries, food allergy is a growing epidemic in pediatric populations with a substantial impact on health-related quality of life. As such, there are great efforts underway to unravel the mechanisms of oral mucosal tolerance and to better define the factors related to host and allergen exposure that contribute to the aberrant immune response leading to sensitization and clinical food allergy. Although more research is needed to eventually develop targeted treatment and prevention strategies, this review highlights our current understanding of the pathogenesis of IgE-mediated food allergy

Allergist-Reported Trends in the Practice of Food Allergen Oral Immunotherapy

Food allergen oral immunotherapy (OIT) is an experimental, immune-modifying therapy that may induce clinical desensitization in some patients. OIT is still in early phase clinical research, but some provider may offer OIT as a clinical service. To understand the current practices of allergists performing OIT an on-line survey was emailed to members of the American Academy of Allergy Asthma and Immunology. Among 442 respondents, 61 (13.8%) reported participating in OIT, including 28 in non-academic settings. Informed consent for OIT was obtained by 91.3%, IRB approval by 47.7% and Investigational New Drug (IND) approval by 38.1%. Compared to non-academic participants, more academic participants used peanut OIT, obtained IRB and IND (p <0.0001 respectively), and challenged patients prior to entry (p=0.008). More non-academic providers billed the patient or insurance for reimbursement (p<0.0001). Low reported regard for the importance for FDA approval or a standardized product (increased odds), and high regard for better safety data (decreased odds) were associated with considering to offer OIT as a service. Significant differences exist in OIT occurring in academic vs. non-academic settings. Further assessment is needed regarding the different motivations and practice styles among providers offering OIT, and those considering doing so

Using Media Messaging to Promote Healthful Eating and Physical Activity among Urban Youth

National trends show consistent increases, as well as racial and ethnic dis- parities, in the prevalence of overweight children and adolescents. Such disparity is evident regarding behaviors such as a poor diet and a lack of physical activity and in the prevalence and outcomes of associated health problems. It has been suggested that grounding interventions in cultural traditions and norms are critical for preventing obesity among ethnic and racial minority youth; however, with some notable exceptions, few community interventions have used this approach. Moreover, urban minority youth may face additional barriers to healthful eating and physical activity behaviors, such as limited environmental and social support systems. Thus, there is a great need for culturally rele- vant community-based programs to serve them

Oral and sublingual immunotherapy for food allergy: current progress and future directions

Food allergies are increasing in prevalence and present an emerging epidemic for westernized countries. Strict dietary avoidance is the only approved management for food allergy, but accidental exposures regularly occur, leading to significant patient anxiety and decreased quality of life. Over the past decade, oral and sublingual immunotherapies have emerged as potential treatments for food allergy. While several small clinical trials have demonstrated that immunotherapy can desensitize food-allergic individuals, strategies for further enhancing safety and definitively establishing long-term efficacy are needed. This review presents an overview of recent oral and sublingual immunotherapy trials, and provides a glimpse into what the next generation of food immunotherapy may entail

Clinical Management of Food Allergy

Food allergies have become a growing public health concern. Currently the standard of care focuses on avoidance of trigger foods, education, and treatment of symptoms following accidental ingestions. Here we provide a framework for primary care physicians and allergists for the diagnosis, management, and treatment of pediatric food allergy

Current Options for the Treatment of Food Allergy

Food allergy is increasing in prevalence; as a result, there is intense focus on developing safe and effective therapies. Current methods of specific immunotherapy include oral, sublingual, and epicutaneous, while nonspecific methods that have been investigated include: Chinese herbal medicine, probiotics, and anti-IgE antibodies. Although some studies have demonstrated efficacy in inducing desensitization, questions regarding safety and the potential for achieving immune tolerance remain. Although some of these therapies demonstrate promise, further investigation is required before their incorporation into routine clinical practice

Impact of Allergic Reactions on Food-Specific IgE Concentrations and Skin Test Results

Although there is concern that food allergic reactions may negatively affect the natural history of food allergy, the impact of reactions on food-specific IgE (sIgE) or skin prick tests is unknown

Long-term treatment with egg oral immunotherapy enhances sustained unresponsiveness that persists after cessation of therapy

We previously reported results of a randomized, placebo-controlled study of egg oral immunotherapy (eOIT), in which 27.5% of subjects achieved sustained unresponsiveness (SU) after 2 years. Here we report results of treatment through 4 years and long-term follow-up

Novel baseline predictors of adverse events during oral immunotherapy in children with peanut allergy

Though peanut oral immunotherapy (OIT) is a promising investigational therapy, its potential is limited by substantial adverse events (AEs), which are relatively understudied

Sustained unresponsiveness to peanut in subjects who have completed peanut oral immunotherapy

Although peanut oral immunotherapy (OIT) has been conclusively shown to cause desensitization, it is currently unknown whether clinical protection persists after stopping therapy