Food allergy across the globe

Vanitha Sampath; Elissa M Abrams; Bahman Adlou; Cezmi Akdis; Mübeccel Akdis; Helen A Brough; Susan Chan; Pantipa Chatchatee; R Sharon Chinthrajah; Renata Rodrigues Cocco; Antoine Deschildre; Philippe Eigenmann; Cesar Galvan; Ruchi Gupta; Elham Hossny; Jennifer J Koplin; Gideon Lack; Michael Levin; Lynette P Shek; Mika Makela; David Mendoza-Hernandez; Antonella Muraro; Nikolaos G Papadopoulous; Ruby Pawankar; Kirsten P Perrett; Graham Roberts; Cansin Sackesen; Hugh Sampson; Mimi L K Tang; Alkis Togias; Carina Venter; Christopher Michael Warren; Lisa M Wheatley; Gary W K Wong; Kirsten Beyer; Kari C Nadeau; Harald Renz

doi:10.1016/j.jaci.2021.10.018

Food allergy across the globe

J Allergy Clin Immunol. 2021 Dec;148(6):1347-1364. doi: 10.1016/j.jaci.2021.10.018.

Authors

Vanitha Sampath¹, Elissa M Abrams², Bahman Adlou¹, Cezmi Akdis³, Mübeccel Akdis³, Helen A Brough⁴, Susan Chan⁴, Pantipa Chatchatee⁵, R Sharon Chinthrajah¹, Renata Rodrigues Cocco⁶, Antoine Deschildre⁷, Philippe Eigenmann⁸, Cesar Galvan⁹, Ruchi Gupta¹⁰, Elham Hossny¹¹, Jennifer J Koplin¹², Gideon Lack⁴, Michael Levin¹³, Lynette P Shek¹⁴, Mika Makela¹⁵, David Mendoza-Hernandez¹⁶, Antonella Muraro¹⁷, Nikolaos G Papadopoulous¹⁸, Ruby Pawankar¹⁹, Kirsten P Perrett¹², Graham Roberts²⁰, Cansin Sackesen²¹, Hugh Sampson²², Mimi L K Tang¹², Alkis Togias²³, Carina Venter²⁴, Christopher Michael Warren¹⁰, Lisa M Wheatley²³, Gary W K Wong²⁵, Kirsten Beyer²⁶, Kari C Nadeau²⁷, Harald Renz²⁸

Affiliations

¹ Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, Calif; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, Calif.
² Department of Paediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Canada; Department of Paediatrics, Division of Allergy and Immunology, University of British Columbia, Vancouver, Canada.
³ Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
⁴ Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine and Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service and Evelina Children's Hospital, Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom.
⁵ Pediatric Allergy and Clinical Immunology Research Unit, Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
⁶ Albert Einstein Medical School, São Paulo, Brazil.
⁷ CHU Lille, University of Lille, Pediatric Pulmonology and Allergy Unit, Hôpital Jeanne de Flandre, Lille, France.
⁸ University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
⁹ National Institute of Children Health, National Reference Center of Allergy, Asthma and Immunology, Lima, Peru; International Clinic, B&D Health Clinic, Lima, Peru.
¹⁰ Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
¹¹ Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
¹² Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
¹³ Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa; inVIVO Planetary Health Group of the Worldwide Universities Network.
¹⁴ Department of Paediatrics, National University of Singapore, Singapore, Singapore.
¹⁵ Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
¹⁶ Allergy Service, Instituto Nacional de Pediatria, Mexico City, Mexico.
¹⁷ Food Allergy Centre, Department of Woman and Child Health, Padua University Hospital, Padua, Italy.
¹⁸ Allergy Department, National and Kapodistrian University of Athens, Athens, Greece; Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom.
¹⁹ Department of Pediatrics, Nippon Medical School, Sendagi, Bunkyo-ku, Tokyo, Japan.
²⁰ Clinical and Experimental Sciences & Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Hospital, Southampton, United Kingdom; David Hide Asthma and Allergy Research Centre, St Mary' Hospital, Isle of Wight, United Kingdom.
²¹ Division of Pediatric Allergy, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey.
²² The Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
²³ Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
²⁴ Pediatric Allergy and Immunology, University of Colorado/Childrens Hospital Colorado, Boulder, Colo.
²⁵ Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, Hong Kong.
²⁶ Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany.
²⁷ Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, Calif; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, Calif. Electronic address: [email protected].
²⁸ Institute of Laboratory Medicine, Philipps University Marburg, Member of the German Center for Lung Research (DZL), Member of Universities Giessen and Marburg Lung Center, Marburg, Germany; Department of Clinical Immunology and Allergology, Laboratory of Immunopathology, Sechenov University, Moscow, Russia.

PMID: 34872649
DOI: 10.1016/j.jaci.2021.10.018

Abstract

The prevalence of food allergy (FA) is increasing in some areas of the globe, highlighting the need for better strategies for prevention, diagnosis, and therapy. In the last few decades, we have made great strides in understanding the causes and mechanisms underlying FAs, prompting guideline updates. Earlier guidelines recommended avoidance of common food allergens during pregnancy and lactation and delaying the introduction of allergenic foods in children aged between 1 and 3 years. Recent guidelines for allergy prevention recommend consumption of a healthy and diverse diet without eliminating or increasing the consumption of allergenic foods during pregnancy or breast-feeding. Early introduction of allergenic foods is recommended by most guidelines for allergy prevention after a period of exclusive breast-feedng (6 months [World Health Organization] or 4 months [European Academy of Allergy and Clinical Immunology]). New diagnostics for FA have been developed with varied availability of these tests in different countries. Finally, the first oral immunotherapy drug for FA was approved by the US Food and Drug Administration and European Medicines Agency in 2020. In this review, we will address the global prevalence of FA, our current understanding of the causes of FA, and the latest guidelines for preventing, diagnosing, and treating FA. We will also discuss similarities and differences between FA guidelines.

Keywords: Food allergy; epidemiology; guidelines; prevention; treatment.

Publication types

Review

MeSH terms

Allergens / immunology
Animals
Breast Feeding
Child, Preschool
Desensitization, Immunologic / methods*
Diet Therapy
Female
Food
Food Hypersensitivity / diagnosis
Food Hypersensitivity / epidemiology*
Food Hypersensitivity / therapy
Humans
Infant
Practice Guidelines as Topic
Pregnancy
Prevalence

Substances

Allergens