Journal of food allergy最新文献

{"title":"Epinephrine availability and allergen avoidance behaviors among caregivers of young children with food allergy.","authors":"Linda J Herbert, Frances Cooke, Adi Chazoom, Sabrina Sigel, Ashley Ramos","doi":"10.2500/jfa.2025.7.240065","DOIUrl":"10.2500/jfa.2025.7.240065","url":null,"abstract":"<p><strong>Background: </strong>Parents are primary caregivers for young children with food allergy. Although food allergy-related caregiver stress is well documented, little is known about caregivers' daily food allergy management behaviors such as identifying safe foods and epinephrine availability.</p><p><strong>Objective: </strong>This study characterized caregivers' daily food allergy management behaviors and identified potential areas of food allergy education and intervention.</p><p><strong>Methods: </strong>Eighty-three primary caregivers (91% women) of young children (mean ± standard deviation age 3.16 ± 1.33 years; 37% girls, 65% White), diagnosed with an immunoglobulin E-mediated food allergy, were recruited from pediatric food allergy clinics. Participants completed two separate food allergy management 24-hour recall-caregiver interviews. Summary statistics were calculated to characterize overall caregiver food allergy management behaviors with regard to their young children's snacks and meals.</p><p><strong>Results: </strong>The majority of meals and/or snacks were eaten at home (64.4%) or daycare and/or school (23.4%). Adults observed 99.4% of meals and/or snacks (70.1% by parents). Epinephrine autoinjectors were available for 95.8% of meals and/or snacks, usually in a nearby room (82.1%). Most foods and/or beverages (87.8%) were prepared at home and, for most (98.2%), the caregiver did not take a specific action that day to ensure the food was allergen-free, but some caregivers checked the ingredients on an earlier date (21.3%) or on the general product (30.3%).</p><p><strong>Conclusion: </strong>Analysis of results indicated frequent epinephrine availability but infrequent use of behaviors that verify foods as allergen-free when the food is ingested, which may place children at risk of allergic reactions and indicates a need for clinician education on food safety decision-making. The findings highlight the need for support for primary caregivers, who are preparing the majority of children's meals and/or snacks, and education and/or policy for daycare and/or schools where many meals are ingested.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"33-38"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of sublingual immunotherapy for treatment of peanut allergy.","authors":"Hema Chagarlamudi, Hunter G Smith, Edwin H Kim","doi":"10.2500/jfa.2025.7.250007","DOIUrl":"10.2500/jfa.2025.7.250007","url":null,"abstract":"<p><strong>Background: </strong>Peanut allergy remains a common problem that persists into adulthood for most patients, with risks of accidental ingestion and poor quality of life. Oral immunotherapy (OIT) and anti-immunoglobulin E (IgE) therapy are effective options for peanut allergy; however, each therapy has limitations, which makes them not ideal for all patients.</p><p><strong>Objective: </strong>The objective was to summarize recent studies that support sublingual immunotherapy (SLIT) for peanut allergy as an alternative option to OIT and anti-IgE therapy, and to discuss practical considerations for its use in clinical practice.</p><p><strong>Methods: </strong>Published reports of SLIT for the treatment of peanut allergy from the past 15 years were identified. Efficacy as measured by food challenges was compared across studies as well as dosing reactions during SLIT therapy.</p><p><strong>Results: </strong>Published studies of peanut SLIT demonstrate significant increases in reaction threshold after therapy. When considering desensitization, higher thresholds were reported with younger age at initiating therapy. Furthermore, the potential for a 3-month remission was seen for toddlers after treatment. Adverse effects with SLIT were similar across the ages, with transient oropharyngeal pruritus being most commonly reported. Severe symptoms that require treatment with epinephrine have generally not been reported. Despite the reassuring safety, withdrawal from therapy was common in older participants. Key questions remain with regard to the minimum duration of sublingual administration, optimal maintenance dose, and best measures of treatment efficacy.</p><p><strong>Conclusion: </strong>Peanut SLIT has been extensively studied, which demonstrated desensitization at levels that approach OIT while also having a simple administration and reassuring safety that may make it a good option for peanut allergy alongside OIT and anti-IgE therapy.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"14-20"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clearing the path: Food allergy considerations for military applicants.","authors":"Vishaka R Hatcher, Karla E Adams","doi":"10.2500/jfa.2025.7.250006","DOIUrl":"10.2500/jfa.2025.7.250006","url":null,"abstract":"<p><strong>Background: </strong>Military and civilian allergists can be consulted for their expertise in food allergy to guide medical evaluations for military service applicants. Military accession (acceptance) standards with regard to food allergy can be daunting, with added complexity when considering service-specific broadening of guidelines and waiver tolerance. The allergist plays a critical role in evaluating patients with food-related concerns who are interested in military service.</p><p><strong>Objective: </strong>The purpose of this short communication is to aid in understanding of current military medical standards and diagnostic protocols related to food allergies in recruitment and enlistment, identification of food reactions that may impact candidacy for military accession, and provide strategies to address the food-related condition and help navigate the military medical evaluation process.</p><p><strong>Methods: </strong>We conducted a thorough review of current applicable military standard guidelines for accession pertinent to food allergies. Through review of Department of Defense medical standard guidelines as well as some service-specific initiatives to expand accessions, allergists can systematically steer through the evaluation process to support military applicants, clearing the path for accession.</p><p><strong>Results: </strong>We provide case-based recommendations to guide allergists in the evaluation of patients with possible food allergy who are interested in application for military service.</p><p><strong>Conclusion: </strong>Through appropriate use of published medical standards and evidence-based practice with strategic stepwise evaluation, the allergist can help clear the path for military applicants in the accessions process.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"42-45"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food allergy thresholds, context, and balance in 2025.","authors":"Marcus S Shaker, Jason Sanders, Aikaterini Anagnostou","doi":"10.2500/jfa.2025.7.250002","DOIUrl":"10.2500/jfa.2025.7.250002","url":null,"abstract":"<p><p>Food allergy impacts are far-reaching, across individuals, families, and societies, and affect both nutrition and psychological health. Understanding risk in context as well as thresholds of reactivity can help to improve food allergy management. These strategies can provide empowerment and improve quality of life. Food allergy thresholds and reaction severity can vary but both tend toward stability, at least in the short-term. An understanding of food allergen thresholds may better leverage active food allergy management as well as better tailor the most appropriate avoidance in selected individuals. Shared decision-making is central to operationalizing food allergen thresholds.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant anaphylaxis and epinephrine use: Can we improve acute management?","authors":"Aikaterini Anagnostou, Matthew Greenhawt, S Shahzad Mustafa, Jay A Lieberman, Marcus Shaker","doi":"10.2500/jfa.2025.7.240067","DOIUrl":"10.2500/jfa.2025.7.240067","url":null,"abstract":"<p><strong>Background: </strong>Anaphylaxis is a serious systemic hypersensitivity reaction that is rapid in onset and may cause death.</p><p><strong>Methods: </strong>The true prevalence of infant anaphylaxis is unknown, but such cases may be increasing in presentation of these patients to emergency departments, with studies that evaluate health-care utilization after implementation of early introduction guidelines that report an increase in the use of emergency department for food-related visits as well as an increase in epinephrine prescriptions for infants.</p><p><strong>Results: </strong>Reasons for these increases may include early food introduction as well as therapeutic interventions such as early life or preschool oral immunotherapy.</p><p><strong>Conclusion: </strong>Infant anaphylaxis presents many diagnostic challenges, including poor recognition attributable to confusing signs and symptoms that may be age specific, and risk for inadequate acute management.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"39-41"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to manage asthma in a food-allergic patient: A practical approach.","authors":"Douglas P Mack","doi":"10.2500/jfa.2025.7.250008","DOIUrl":"10.2500/jfa.2025.7.250008","url":null,"abstract":"<p><p>This article examines the intricate interplay between food allergy and asthma by focusing on the challenges of managing food allergy in patients with asthma. Although asthma is a prevalent comorbidity in food allergy, often > 50% among older children, its impact on food allergy outcomes remains not fully understood. Studies indicate a higher prevalence of asthma among individuals experiencing fatal anaphylaxis, yet there is no consistent evidence that supports a direct causal link between food allergy and the development of asthma. Clinicians and patients often overestimate asthma control, which leads to underestimated risks associated with severe food allergy reactions. This article underscores the critical need for optimal asthma control before and during oral food challenges and dietary advancement therapies, highlighting the heightened risk of severe reactions in individuals with poorly controlled asthma. Whereas biologics such as omalizumab show promise in enhancing asthma control and increasing food allergy thresholds, a comprehensive, multifaceted approach that involves diligent asthma management, patient education, and appropriate treatment strategies is essential for ensuring safe and effective management of food allergy in individuals with asthma. Integrated management, which addresses both conditions concurrently, is vital for improving patient safety and quality of life.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"21-26"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights into food allergy and anaphylaxis management.","authors":"Aikaterini Anagnostou","doi":"10.2500/jfa.2025.7.250009","DOIUrl":"10.2500/jfa.2025.7.250009","url":null,"abstract":"","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selecting patients for food allergy therapy.","authors":"Aikaterini Anagnostou","doi":"10.2500/jfa.2025.7.250003","DOIUrl":"10.2500/jfa.2025.7.250003","url":null,"abstract":"<p><strong>Background: </strong>Food allergies pose a significant burden on the daily life of individuals with food allergy, including dietary, psychosocial, and economic impact. The management of food allergy has shifted recently from previous passive avoidance approaches to current active therapeutic interventions.</p><p><strong>Objective: </strong>This article aims to discuss selection of patients with food allergies for different therapies.</p><p><strong>Methods: </strong>Published literature on risks and benefits of various therapies as well as articles on shared decision-making were reviewed for this article. Key papers are included.</p><p><strong>Results and conclusion: </strong>In addition to the two U.S. Food and Drug Administration approved therapies currently available (for oral peanut immunotherapy and for treatment of single and/or multiple food allergies), many novel treatments are on the horizon. Alternative forms of food immunotherapy, such as epicutaneous and sublingual, as well as a variety of new biologics are under development. When selecting patients for therapy, it is important to consider multiple factors, including eligibility, age, type of food, history of life-threatening reactions, baseline quality of life, and the presence of atopic comorbidities. As the food allergy landscape becomes enriched with novel treatment modalities, choice of the appropriate therapy for each individual is more challenging. Avoidance also remains an acceptable strategy for those who prefer this approach.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"3-6"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omalizumab in food allergy: Risks and benefits.","authors":"S Shahzad Mustafa, Kristin Sokol","doi":"10.2500/jfa.2025.7.250004","DOIUrl":"10.2500/jfa.2025.7.250004","url":null,"abstract":"<p><p>Omalizumab is approved for the management of immunoglobulin E-mediated food allergy in individuals ages ≥ 1 year. Approval for food allergy followed the Omalizumab as Monotherapy and as Adjunct Therapy to Multi-Allergen OIT in Food Allergic Participants (OUtMATCH) study, which demonstrated that omalizumab increases the threshold dose of multiple food allergens needed to elicit an allergic reaction. Despite the demonstrated efficacy in food allergy and favorable safety profile, many questions remain. This review addresses the efficacy of omalizumab for the management of food allergy, as monotherapy, and in conjunction with oral immunotherapy. Safety in children is paramount, and this review addresses noted adverse events of anaphylaxis and malignancy. There is minimal knowledge with regard to the real-world impact on food allergy-related quality of life. Many questions still remain, including identifying who is the ideal patient for omalizumab, determining the role of oral food challenges before and during therapy with omalizumab, evaluating food allergy tolerance while on treatment, and optimizing the cost-effectiveness of this efficacious and well-tolerated management option for food allergy.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"7 1","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying thresholds of reaction for different foods.","authors":"Jay Adam Lieberman","doi":"10.2500/jfa.2024.6.240006","DOIUrl":"https://doi.org/10.2500/jfa.2024.6.240006","url":null,"abstract":"<p><p>Current food allergy management universally treats all patients with food allergy as being at risk for anaphylaxis (with the exception perhaps of pollen food allergy syndrome). Thus, patients are told to avoid the allergenic food in all potentially allergic forms and amounts. However, research over the past 2 decades has shown that many patients will tolerate small amounts of the allergen without any allergic reaction. Thus, if one were able to identify the threshold of reactivity, this could change management. At the population level, establishing levels at which the vast majority of patients (e.g., 95%) do not react could have public health ramifications, such as altering labeling laws. At the individual patient level, personal threshold levels could determine avoidance strategies, affect quality of life, and alter treatment decisions, e.g., oral immunotherapy starting doses. In this review, threshold data for various allergens and their potential effect on the management of the patient with food allergy are examined.</p>","PeriodicalId":73751,"journal":{"name":"Journal of food allergy","volume":"6 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}