Vaccine approaches for food allergy

The prevalence of food allergy appears to be increasing. Hypersensitivity reactions to foods account for significant morbidity and mortality. The current standard of care for treatment of food allergies is limited to diligent dietary avoidance and prompt pharmacotherapy should an unexpected ingestion result in a reaction. Complex interactions between dietary antigens, the gastrointestinal flora, and the gut associated mucosal system drive host immune responses towards oral tolerance or hypersensitivity. Oral tolerance is achieved by regulatory T cell suppression of immune responses and by clonal anergy. Many novel therapies to treat food allergies are currently under investigation. Most utilize antigen-specific strategies in an attempt to induce oral tolerance. Oral immunotherapy (OIT) has been the focus of much attention. Early studies had established the safety and efficacy of OIT, but its ability to induce long-term tolerance versus a state of desensitization remains to be firmly established. Nevertheless, recent advances in our understanding of oral tolerance induction has increased optimism that disease-modifying therapies for food allergies will soon be the standard of care.