IgE and non-IgE-mediated food allergy: treatment in 2007.
OBJECTIVE
Our understanding of the mechanism of food allergy has substantially increased over the past decade. Food allergies can be classified into those that are IgE mediated and those that are non-IgE mediated.


RESULTS
Various advances have been made in treating IgE-mediated food allergies. A phase II clinical trial of a second anti-IgE antibody, omalizumab, was recently initiated in subjects with peanut allergy, but was stopped as a result of safety concerns after severe reactions occurred during initial oral challenges. Oral immunotherapy is showing promise in various studies on patients with IgE-mediated food allergies. Gastrointestinal food allergic disorders involving non-IgE-mediated food allergies have recently received attention, particularly eosinophilic esophagitis. Although amino acid-based formula therapy remains the most successful in controlling inflammation and symptoms in these disorders, other therapeutic options including various dietary elimination protocols and swallowed fluticasone are showing success. Anti-IL-5 therapy may prove to be a promising future therapeutic option for refractory patients.


CONCLUSIONS
Although there are no specific therapeutic recommendations for many IgE-mediated and non-IgE-mediated food allergic disorders besides allergen avoidance, various novel approaches are currently being investigated and may influence treatment approaches in the future.
Chehade
Mirna
M
Division of Gastroenterology/Nutrition, Division of Allergy/Immunology, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. mirna.chehade@mssm.edu
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000596:Amino Acids / Q000008:administration & dosage; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D005512:Food Hypersensitivity / Q000628:therapy*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D015848:Interleukin-5 / Q000037:antagonists & inhibitors; D008516:Medicine, Chinese Traditional
D000305:Adrenal Cortex Hormones; D000596:Amino Acids; D000888:Antibodies, Anti-Idiotypic; D015848:Interleukin-5; C026408:anti-IgE antibodies; D007073:Immunoglobulin E