[Food allergy or food intolerance?]

Area of Science:

• Immunology
• Gastroenterology
• Clinical Medicine

Context:

• Adverse food reactions encompass a wide spectrum of clinical presentations.
• Accurate classification is crucial for effective patient management.
• Current diagnostic approaches may benefit from a mechanism-based framework.

Purpose:

• To present a pathophysiologically-based classification of adverse food reactions.
• To differentiate between immune-mediated and non-immune-mediated food reactions.
• To provide a framework for improved diagnosis and management strategies.

Summary:

• Adverse food reactions are broadly divided into immune-mediated (e.g., IgE-mediated food allergy, eosinophilic esophagitis, food protein-induced enterocolitis syndrome, celiac disease) and non-immune-mediated (food intolerances) categories.
• Non-immune-mediated reactions include intoxications, pharmacologic, metabolic, physiologic, psychologic, and reactions with unknown mechanisms.
• This classification system aims to clarify the underlying mechanisms of adverse food reactions.

Impact:

• Facilitates a more targeted diagnostic approach to adverse food reactions.
• Improves clinical decision-making for food intolerances and allergies.
• Enhances understanding of the diverse pathophysiology of adverse food reactions.