Clinical aspects of food allergy

Food allergy affects 2.5% of adults and 6-8% of children, and is a leading cause of life-threatening anaphylactic episodes. Food allergy is defined as an adverse reaction to foods that is mediated immunologically and involves specific IgE or non-IgE mechanisms. In this review only IgE-related food allergy will be considered. Many food allergens are glycoproteins, but they do not share any striking biochemical similarities. The definition of many food proteins at the molecular level has tremendously facilitated our understanding of clinical syndromes and seemingly bizarre observations. Clinical manifestations of food allergy include symptoms of the gastrointestinal, cutaneous and respiratory systems, as well as systemic anaphylaxis. The diagnosis of food allergy involves a stepwise approach, including medical history taking, demonstration of specific IgE and confirmation by oral food challenge. The management of the food-allergic patient at present consists of avoidance of the culprit food and education, while future advances may include specific immunotherapy with modified allergens or DNA vaccination.