School of Medicine, University of Galway, Galway, Ireland.
Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Allergy. 2023 Sep;78(9):2344-2360. doi: 10.1111/all.15749. Epub 2023 May 12.
While both the incidence and general awareness of food allergies is increasing, the variety and clinical availability of therapeutics remain limited. Therefore, investigations into the potential factors contributing to the development of food allergy (FA) and the mechanisms of natural tolerance or induced desensitization are required. In addition, a detailed understanding of the pathophysiology of food allergies is needed to generate compelling, enduring, and safe treatment options. New findings regarding the contribution of barrier function, the effect of emollient interventions, mechanisms of allergen recognition, and the contributions of specific immune cell subsets through rodent models and human clinical studies provide novel insights. With the first approved treatment for peanut allergy, the clinical management of FA is evolving toward less intensive, alternative approaches involving fixed doses, lower maintenance dose targets, coadministration of biologicals, adjuvants, and tolerance-inducing formulations. The ultimate goal is to improve immunotherapy and develop precision-based medicine via risk phenotyping allowing optimal treatment for each food-allergic patient.
尽管食物过敏的发病率和普遍认知度都在上升,但治疗方法的种类和临床应用仍然有限。因此,需要研究导致食物过敏(FA)的潜在因素和自然耐受或诱导脱敏的机制。此外,需要详细了解食物过敏的病理生理学,以产生有说服力、持久和安全的治疗选择。关于屏障功能的作用、保湿干预的效果、过敏原识别机制以及通过啮齿动物模型和人体临床研究特定免疫细胞亚群的贡献的新发现提供了新的见解。随着首个批准用于治疗花生过敏的疗法,FA 的临床管理正朝着更不密集、更具替代性的方法发展,包括固定剂量、更低的维持剂量目标、联合使用生物制剂、佐剂和诱导耐受的制剂。最终目标是通过风险表型改善免疫疗法并开发基于精准医学的方法,为每个食物过敏患者提供最佳治疗。