title: Prevention of food allergy.
abstract: The past few decades have witnessed an increase in the prevalence of IgE-mediated food allergy (FA). For prevention strategies to be effective, we need to understand the causative factors underpinning this rise. Genetic factors are clearly important in the development of FA, but given the dramatic increase in prevalence over a short period of human evolution, it is unlikely that FA arises through germline genetic changes alone. A plausible hypothesis is that 1 or more environmental exposures, or lack thereof, induce epigenetic changes that result in interruption of the default immunologic state of tolerance. Strategies for the prevention of FA might include primary prevention, which seeks to prevent the onset of IgE sensitization; secondary prevention, which seeks to interrupt the development of FA in IgE-sensitized children; and tertiary prevention, which seeks to reduce the expression of end-organ allergic disease in children with established FA. This review emphasizes the prevention of IgE-mediated FA through dietary manipulation, among other strategies; in particular, we focus on recent interventional studies in this field.
authors.affiliation: King's College London, King's Health Partners, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, and the Department of Paediatric Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: du Toit
authors.affiliation: King's College London and St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Teresa
authors.initials: T
authors.lastname: Tsakok
authors.affiliation: Imperial College London, London, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Lack
authors.affiliation: King's College London, King's Health Partners, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, and the Department of Paediatric Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. Electronic address: gideon.lack@kcl.ac.uk.
authors.forename: Gideon
authors.initials: G
authors.lastname: Lack
mesh_terms: D004035:Diet Therapy / Q000379:methods*; D044127:Epigenesis, Genetic; D005260:Female; D005512:Food Hypersensitivity / Q000235:genetics / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007108:Immune Tolerance; D007073:Immunoglobulin E; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000276:immunology; D012307:Risk Factors
chemical_list: D007073:Immunoglobulin E
keywords: Food allergy; atopic dermatitis; cow's milk allergy; egg allergy; oral food challenge; peanut allergy; specific IgE