Food allergy in children—the current status and the way forward

Abstract

Food allergy in children is a major health concern, and its prevalence is rising. It is often over-diagnosed by parents, resulting occasionally in unnecessary exclusion of some important food. It also causes stress, anxiety, and even depression in parents and affects the family’s quality of life. Current diagnostic tests are useful when interpreted in the context of the clinical history, although cross-sensitivity and inability to predict the severity of the allergic reactions remain major limitations. Although the oral food challenge is the current gold standard for making the diagnosis, it is only available to a small number of patients because of its requirement in time and medical personnel. New diagnostic methods have recently emerged, such as the Component Resolved Diagnostics and the Basophil Activation Test, but their use is still limited, and the latter lacks standardisation. Currently, there is no definite treatment available to induce life-long natural tolerance and cure for food allergy. Presently available treatments only aim to decrease the occurrence of anaphylaxis by enabling the child to tolerate small amounts of the offending food, usually taken by accident. New evidence supports the early introduction of the allergenic food to infants to decrease the incidence of food allergy. If standardised and widely implemented, this may result in decreasing the prevalence of food allergy.

Keywords: Oral food challenge; Oral immunotherapy; Allergens; Anaphylaxis; Desensitisation; Immunoglobulin E; Eosinophilic gastrointestinal diseases; Histamine; Mast cells; Basophil activation test

Core Tip: Food allergy in children is a potentially serious condition with an increasing prevalence. Current diagnostic tests are useful when interpreted in the context of the clinical history. The oral food challenge is the current gold standard for making the diagnosis, but its use is limited. New diagnostic methods have recently emerged. Currently, there is no definite treatment to induce life-long natural tolerance and cure for this condition, and available treatments only aim to decrease the occurrence of anaphylaxis. New evidence supports the early introduction of the allergenic food to infants to decrease the incidence of food allergy.