title: The Natural History of Food Allergy.
abstract: On a population level, it is well recognized that some IgE-mediated childhood food allergies, such as milk and egg allergies, are more likely to resolve than others, such as peanut and tree nuts allergies. Unfortunately, some studies suggest that resolution rates may have slowed compared with impressions from past decades. The clinician can apply the knowledge of the epidemiology of these allergies to describe likely patient outcomes, and direct management in a general manner. However, the ability to evaluate and predict the natural course of specific food allergies for individual patients is essential to inform personalized patient care. Data are accumulating to assist in identifying whether a child's allergy has likely resolved, informing the timing of oral food challenges or subsequent testing. Exciting recent studies are increasingly identifying early prognostic markers as well. Emerging food allergy therapies carry risks and costs. Identifying which egg-allergic patient has likely persistent allergy, and which patient with peanut allergy may experience natural resolution, is becoming an important goal to identify the best candidates for these therapies. Although more work needs to be done to identify reliable predictive markers and validate them, there is already much known about the natural course of food allergies that can be applied by the clinician to improve patient care.
authors.affiliation: Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass. Electronic address: jrsavage@partners.org.
authors.forename: Jessica
authors.initials: J
authors.lastname: Savage
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Scott
authors.initials: S
authors.lastname: Sicherer
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
authors.forename: Robert
authors.initials: R
authors.lastname: Wood
mesh_terms: D017668:Age of Onset; D000485:Allergens / Q000276:immunology*; D000818:Animals; D010367:Arachis / Q000009:adverse effects; D002648:Child; D004527:Egg Proteins / Q000276:immunology; D005512:Food Hypersensitivity / Q000453:epidemiology* / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008894:Milk Proteins / Q000276:immunology; D044382:Population Groups; D014481:United States / Q000453:epidemiology
chemical_list: D000485:Allergens; D004527:Egg Proteins; D008894:Milk Proteins; D007073:Immunoglobulin E
keywords: Egg; Food allergy; Milk; Natural history; Peanut; Soy; Tree nut; Wheat