Immunotherapy of Food Allergy: a Comprehensive Review

Christine Y. Y. Wai, Nicki Y. H. Leung, Patrick S. C. Leung, Ka Hou Chu

Food allergy imposes a severe global health burden, and thus, there is a dire need for safe and effective treatments. Allergen-specific immunotherapy (AIT) is currently the only approach to restore immune tolerance through administrating increasing doses of allergen extracts. Unfortunately, the development of AIT for food allergies has been impeded by the frequent anaphylactic side effects during the course of treatment. The emergence of component-resolved diagnosis has greatly improved our ability to identify causative allergens and revolutionized the design of AIT. Molecular features such as IgE-binding epitopes and T cell epitopes have been elucidated in most major food allergens, inspiring the use of multiple strategies to manipulate the allergens and design safer alternatives to AIT. Although these allergen-modifying approaches are currently restricted to preclinical characterization and animal studies, the employment of these strategies has certainly paved the way for improving the safety of existing AIT. A safe and effective AIT for food allergy is not far beyond reach.