IgE-Mediated Food Allergy

The prevalence of IgE-mediated food allergy has been increasing globally over the past two decades and now affects 4-6% of the pediatric population and about 3% of the general population in the United States. The reason for this increase is unknown, but changes in diet, food processing, neonatal exposure to food allergens, use of antibiotics and other medications, and changes in the microbiota are all thought to play some role in this increase. Allergic reactions to foods may provoke mild to severe symptoms in the skin, gastrointestinal tract, and/or respiratory tract and, in some cases, life-threatening or even fatal anaphylaxis. The diagnosis of food allergy requires a detailed history, tests for food-specific IgE antibodies, and often oral food challenges. Treatment consists of strict avoidance of food allergens and education on the management of allergic reactions due to accidental ingestions, including the use of self-injectable epinephrine. With the increasing understanding of the underlying immunopathogenesis of food allergy, a number of immunotherapeutic strategies are being evaluated in clinical trials and show promise of providing more effective approaches to treating food allergy.