Nonallergen-specific Treatments for Food Allergy

Jay A. Lieberman, MD; Julie Wang, MD

Disclosures

Curr Opin Allergy Clin Immunol. 2012;12(3):293-301. 

In This Article

Abstract and Introduction

Abstract

Purpose of review This review summarizes recent reports on nonallergen-specific therapies for food allergy. These therapies are especially appealing for food allergy because unlike allergen-specific immunotherapy, they would allow the treatment of multiple food allergies in a single patient with one therapy.
Recent findings Chinese herbal therapy, anti-IgE, probiotics, engineered lactic acid bacteria, and helminth therapy are all examples of allergen nonspecific therapies that have been investigated in recent years. Although some have only been studied in animal models of food allergy, some are undergoing rigorous, human clinical trials.
Summary Increasing amounts of research are examining the efficacy and safety of nonallergen-specific therapies for food allergy. There is hope that clinicians will have effective treatments either as an alternative or as an adjunct to immunotherapy.

Introduction

With an increasing amount of research being dedicated to the field of food allergy, the once-unattainable idea of an active, readily available, immune-modulating therapy for patients with food allergy may soon be a reality. The majority of published reports and ongoing studies in this field employ allergen-specific immunotherapy to achieve either a state of desensitization, or hopefully, a state of tolerance.[1–6] Although these methods, reviewed in depth by other articles in this issue, show great promise for practicing clinicians and their patients, they may have one inherent drawback in the real world, which is that many food-allergic patients are polysensitized and allergic to multiple foods. For example, if these immunotherapy protocols are employed in everyday practice, what would one do for their patient who is allergic to milk, egg, peanut, and shellfish? Will these patients require a physician-prepared cocktail of allergens for desensitization? Or will they have to be desensitized to one food at a time? One option that circumvents this inevitability is the use of allergen nonspecific therapies. The goal of these therapies is to induce a state of tolerance by altering the global host immune response, rather than that specified to a single allergen. Although this may be a holy grail in the field of allergy, there are some reports to suggest that we are getting closer, as several nonspecific therapies are currently being investigated.

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