Food Allergy: Present and Future Management

Table 1 Potential Strategies for Treating Food Allergy

Therapy	Mechanism	Status
Allergen specific
Sublingual immunotherapy	Controlled prolonged exposure to antigen promotes switch from Th2 to Th1 response via promotion of Treg activity	Clinical trials
Oral immunotherapy	Controlled prolonged exposure to antigen promotes switch from Th2 to Th1 response via promotion of Treg activity	Clinical trials
Heat denatured protein	"Natural" immunotherapy by presenting linear but not conformational epitopes to tolerant patients	Clinical trials are on-going
Engineered protein immunotherapy	Mutated IgE-binding epitopes prevent allergic reaction while maintaining T cell activity	Early stage clinical trials
Peptide vaccine	T cell epitope preservation while preventing IgE-cross linking via small overlapping peptides	Murine models
Plasmid DNA encoded vaccines	Tolerance achieved via endogenous production of antigen	Murine models, but strain specific response. No active development
Allergen-conjugated immunostimulatory sequence	Promote Th1 response via activation of innate immune pathway (toll-like receptors)	Clinical trials with allergic rhinitis
Allergen nonspecific
Monoclonal anti-IgE therapy	Binds and inactivates IgE and prevents stimulation of high affinity IgE-receptor	Monotherapy studies not active, combination studies with other therapies in clinical trials
Chinese herbal medicine	Unknown mechanism, not steroid effect	Early stage clinical trials
Cytokine therapy	Interfere with inflammatory pathways	Clinical trials for eosinophilic esophagitis

ISSN: 1939-4551