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Recent topics on gastrointestinal allergic disorders.

Yoshiyuki Yamada1,2

  • 1Department of Pediatrics, Tokai University School of Medicine, Isehara, Kanagawa, Japan.

Clinical and Experimental Pediatrics
|January 12, 2023
PubMed
Summary

Gastrointestinal food allergies in infants, including FPIES and FPIAP, are increasing, particularly non-IgE-mediated types. Research suggests a link between these allergies and type 2 inflammation, potentially explaining recent trends.

Keywords:
Eosinophilic enteropathyEosinophilic esophagitisFood hypersensitivity

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Area of Science:

  • Gastroenterology
  • Allergology
  • Immunology

Background:

  • Gastrointestinal (GI) food allergies are categorized by immunoglobulin E (IgE) involvement: IgE-mediated, non-IgE-mediated, and mixed.
  • Non-IgE-mediated GI food allergies, prevalent in infants, include food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE).
  • Unique phenotypes and increasing incidence of GI allergies, including chronic FPIES and hen's-egg FPIES, have been observed in Japan.

Purpose of the Study:

  • To review the classification and recent trends in GI food allergies.
  • To explore the association between GI allergies and eosinophilic gastrointestinal disorders (EGIDs).
  • To investigate the potential role of type 2 inflammation in the rising prevalence of GI allergies.

Main Methods:

  • Literature review and analysis of epidemiological data on GI food allergies.
  • Classification of GI allergies based on IgE involvement and clinical presentation.
  • Examination of the pathological characteristics of EGIDs and their relationship with FPIAP, FPIES, and FPE.

Main Results:

  • Non-IgE-mediated GI food allergies and EGIDs are increasingly recognized, particularly in pediatric populations in Japan.
  • Eosinophilic inflammation is a common feature in various GI allergies, including FPIAP, FPIES, and FPE.
  • Pediatric non-EoE EGIDs in Japan are noted to be persistent and severe, suggesting a need for improved therapies.

Conclusions:

  • Recent increases in GI allergies may be linked to type 2 inflammation.
  • Understanding the interplay between GI allergies and type 2 inflammation is crucial for elucidating disease pathogenesis.
  • Further research into effective therapeutic options for severe pediatric GI allergies is warranted.