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Immunotherapy of Food Allergy: a Comprehensive Review

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Abstract

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.

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Abbreviations

AIT:

Allergen-specific immunotherapy

APCs:

Antigen-presenting cells

BSA:

Bovine serum albumin

DCs:

Dendritic cells

EPIT:

Epicutaneous immunotherapy

FAST:

Food Allergy Specific Immunotherapy

iTreg:

Inducible Treg

LAP:

Latency-associated protein

MHC:

Major histocompatibility complex

nTreg:

Naturally occurring Treg

OBOC:

One-bead-one-compound

OIT:

Oral immunotherapy

OVA:

Ovalbumin

Ovm:

Ovumucoid

PLGA:

Poly(lactic-co-glycolic-acid)

rMet e 1:

Recombinant Met e 1

SLIT:

Sublingual immunotherapy

SPT:

Skin prick test

TCLs:

T cell lines

Th2:

Type II T helper

WAS:

Wiskott-Aldrich syndrome

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Acknowledgements

The authors would like to thank Mr. Yaoyu Gong for his contribution to this review. The work on shellfish allergy of the authors is supported by a grant from the Health and Medical Research Fund (02130206), HKSAR, China. CYY Wai is currently funded by an AXA Postdoctoral Fellowship (AXA Research Fund).

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  1. Simon F.S. Li Marine Science Laboratory, School of Life Sciences, The Chinese University of Hong Kong, Room 201A, Science Park Road, Shatin, N.T., Hong Kong, SAR, China

    Christine Y. Y. Wai, Nicki Y. H. Leung & Ka Hou Chu

  2. Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China

    Christine Y. Y. Wai & Nicki Y. H. Leung

  3. Division of Rheumatology/Allergy, School of Medicine, University of California, Davis, CA, 95616, USA

    Patrick S. C. Leung

  4. Genome and Biomedical Sciences Facility, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA

    Patrick S. C. Leung

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  1. Christine Y. Y. Wai
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  2. Nicki Y. H. Leung
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  3. Patrick S. C. Leung
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Wai, C.Y.Y., Leung, N.Y.H., Leung, P.S.C. et al. Immunotherapy of Food Allergy: a Comprehensive Review. Clinic Rev Allerg Immunol 57, 55–73 (2019). https://doi.org/10.1007/s12016-017-8647-y

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