Current status and future directions in food protein-induced enterocolitis syndrome: An NIAID workshop report of the June 22, 2022, virtual meeting

Anna Nowak-Wegrzyn; Scott H Sicherer; Cem Akin; Sara Anvari; Lisa M Bartnikas; M Cecilia Berin; Theresa A Bingemann; Scott Boyd; Terri Brown-Whitehorn; Supinda Bunyavanich; Antonella Cianferoni; George du Toit; John E Fortunato; Jeffrey D Goldsmith; Marion Groetch; Stephanie A Leonard; Meenakshi Rao; Fallon Schultz; Julie M Schwaninger; Carina Venter; Amity Westcott-Chavez; Robert A Wood; Alkis Togias

doi:10.1016/j.jaci.2024.10.022

Current status and future directions in food protein-induced enterocolitis syndrome: An NIAID workshop report of the June 22, 2022, virtual meeting

J Allergy Clin Immunol. 2024 Nov 7:S0091-6749(24)01166-7. doi: 10.1016/j.jaci.2024.10.022. Online ahead of print.

Authors

Anna Nowak-Wegrzyn¹, Scott H Sicherer², Cem Akin³, Sara Anvari⁴, Lisa M Bartnikas⁵, M Cecilia Berin⁶, Theresa A Bingemann⁷, Scott Boyd⁸, Terri Brown-Whitehorn⁹, Supinda Bunyavanich², Antonella Cianferoni⁹, George du Toit¹⁰, John E Fortunato¹¹, Jeffrey D Goldsmith¹², Marion Groetch², Stephanie A Leonard¹³, Meenakshi Rao¹⁴, Fallon Schultz¹⁵, Julie M Schwaninger¹⁶, Carina Venter¹⁷, Amity Westcott-Chavez¹⁸, Robert A Wood¹⁹, Alkis Togias²⁰

Affiliations

¹ Department of Pediatrics, Hassenfeld Children's Hospital, NYU Grossman School of Medicine, New York, and the Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; Department of Pediatrics, Division of Pediatric Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: [email protected].
² Department of Pediatrics, Division of Pediatric Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
³ Department of Medicine, University of Michigan, Division of Allergy and Clinical Immunology, Ann Arbor, Mich.
⁴ Division of Immunology, Allergy and Retrovirology, Texas Children's Hospital, Baylor College of Medicine, Houston, and Texas Children's Hospital, William T. Shearer Center for Human Immunobiology, Houston, Tex.
⁵ Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, and Harvard Medical School, Boston, Mass.
⁶ Department of Medicine, Division of Allergy/Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill.
⁷ Department of Allergy, Immunology and Rheumatology and the Department of Pediatric Allergy and Immunology, University of Rochester School of Medicine, Rochester, NY.
⁸ Stanford University School of Medicine, Palo Alto, Calif.
⁹ Division of Pediatric Allergy and Immunology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pa.
¹⁰ Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, and the Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom.
¹¹ Gastroenterology, Hepatology and Nutrition, Northwestern University Feinberg School of Medicine, Chicago, Ill.
¹² Department of Pathology, Boston Children's Hospital, Boston, and Harvard Medical School, Boston, Mass.
¹³ Division of Pediatric Allergy & Immunology, Rady Children's Hospital San Diego, University of California, San Diego, Calif.
¹⁴ Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, and Harvard Medical School, Boston, Mass.
¹⁵ Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Rockville, Md.
¹⁶ International FPIES Association (IFPIES), Point Pleasant, NJ.
¹⁷ Children's Hospital Colorado, University of Colorado, Denver, Colo.
¹⁸ IFPIES, Point Pleasant, NJ.
¹⁹ Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
²⁰ Allergy, Immunology and Transplantation, NIAID, National Institutes of Health, Rockville, Md.

PMID: 39521282
DOI: 10.1016/j.jaci.2024.10.022

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food allergy characterized by delayed, protracted vomiting and accompanied by lethargy and pallor, usually 1 to 4 hours after ingesting the food allergen. The pathophysiology of FPIES remains unknown, and currently there are no diagnostic biomarkers available to assess disease activity or its resolution. Over the last 2 decades, FPIES has become increasingly recognized in both pediatric and adult patients. Forty years after the initial FPIES description, the first FPIES code appeared in the International Classification of Diseases, Tenth Revision (ICD-10), and the first international consensus guidelines for the diagnosis and management of FPIES were published. On June 22, 2022, the National Institute of Allergy and Infectious Diseases (NIAID) held its first virtual multidisciplinary workshop on FPIES. Various clinical and translational aspects of FPIES as well as important areas of unmet needs were discussed as priorities for future research during this 2-day virtual workshop. Our report provides a summary of content of the workshop, including updated literature on the topic areas, and also provides critical commentary on the state of FPIES.

Keywords: FPIES; Food allergy; dysautonomia; enteroendocrine cell; food protein–induced enterocolitis syndrome; gut neurophysiology; mast cell; serotonin.