Allergen-Specific Immunotherapy for Food Allergy: Latest Advances in Vaccines

Although great progress has been made to elucidate the molecular and cellular basis of allergic disorders, it is not completely understood why some individuals develop allergic sensitization to some foods, while the majority of individuals are immunologically tolerant. In addition, it is yet not fully understood which is the molecular basis involved in the immunopathogenesis of the mechanisms elicited against the food harmless antigens. Once diagnosis of food allergy is achieved and the offending allergen or allergenic food is identified, the first clinical or even familial indication is avoidance of the suspected food. Currently, there is no definitive treatment for food allergy: the avoidance of food allergens and treatment of food allergen-induced systemic reactions with adrenaline remain the standard of care. This implies that the patients and their family should be well educated about precautionary measures to avoid exposure to the responsible allergen, and foods should be adequately labeled in terms of allergen content. At present, efforts are being made to develop a disease-modifying therapy. Despite the advances achieved in this field in the last decades, there is still no approved immunotherapy for food allergies. Since the first report of immunotherapy in 1911 [1], many efforts have been made by the scientific community to optimize efficacy and minimize toxicity. Immunotherapy is at present a treatment procedure to induce, enhance or suppress an immune response in different immunological disorders (cancer, autoimmunity, allergy, allorecognition, etc). Although allergen specific immunotherapy has been used for the treatment of IgE-mediated allergy for more than a hundred years, the first randomized clinical trial of oral immunotherapy for food allergy was conducted in 2005 [2]. Of note, this therapeutic procedure, although showing great promise, has not been accepted as a routine treatment for food allergy. The induction of adverse reactions during treatment, as well as the uncertainty about longlasting effect after treatment completion, remain as the main drawback of these therapeutic strategies.