The changing geoepidemiology of food allergies

Patrick S Leung, Shang An Shu, Christopher Chang

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


The science of food allergy has been rapidly evolving before our eyes in the past half century. Like other allergic disorders, the prevalence of food allergies has dramatically increased, and coupled with the increased public awareness of anaphylaxis due to food allergy, this has driven an explosion in basic and clinical research in this extremely broad subject. Treatment of food allergies has evolved and practices such as food challenges have become an integral part of an allergy practice. The impact of the increase of food allergy has driven package labeling laws, legislation on emergency treatment availability in schools and other public places, and school policy. But to this day, our knowledge of the pathogenesis of food allergy is still incomplete. There are the most obvious IgE-mediated immediate hypersensitivity reactions, but then multiple previously unidentified conditions such as eosinophilic esophagitis, food protein-induced enterocolitis syndrome, milk protein allergy, food-induced atopic dermatitis, oral allergy syndrome, and others have complicated the diagnosis and management of many of our patients who are unable to tolerate certain foods. Many of these conditions are not IgE-mediated, but may be T cell-driven diseases. The role of T regulatory cells and immune tolerance and the newly discovered immunological role of vitamin D have shed light on the variable clinical presentation of food allergy and the development of new methods of immunotherapy in an example of bench-to-bedside research. Component-resolved diagnostic techniques have already begun to allow us to more precisely define the epitopes that are targeted in food allergic patients. The development of biological modulators, research on genomics and proteomics, and epigenetic techniques all offer promising avenues for new modes of therapy of food allergy in the twenty-first century.

Original languageEnglish (US)
Pages (from-to)169-179
Number of pages11
JournalClinical Reviews in Allergy and Immunology
Issue number3
StatePublished - 2014


  • Biological response modifiers
  • Component-resolved diagnostics
  • Eosinophilic esophagitis
  • Food allergy
  • Galactose-alpha-1,3-galactose
  • Oral immunotherapy
  • T cell
  • T regulatory cell
  • Ticks
  • Traditional Chinese medicine
  • Vitamin D

ASJC Scopus subject areas

  • Immunology and Allergy
  • Medicine(all)


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