Abstract
Food allergy (FA) is a pathological immune response, potentially deadly, induced by exposure to an innocuous and specific food allergen. To date, there is no specific treatment for FAs; thus, dietary avoidance and symptomatic medications represent the standard treatment for managing them. Recently, several therapeutic strategies for FAs, such as sublingual and epicutaneous immunotherapy and monoclonal antibodies, have shown long-term safety and benefits in clinical practice. This review summarizes the current evidence on changes in treating FA, focusing on monoclonal antibodies, which have recently provided encouraging data as therapeutic weapons modifying the disease course.
Highlights
Food Allergy (FA) is a pathological and potentially deadly immune response caused by exposure to an innocuous and specific food allergen [1]
Ligelizumab, called QGE031, is a new humanized monoclonal anti-IgE antibody. It is administered as a subcutaneous injection at a dosage of 24, 72, or 240 mg every two weeks. It was initially tested in a phase II RCT, parallel design, dose-ranging, multicenter trial enrolling adult patients affected by peanut allergy [56]
Known as ANB020 (AnaptysBio), is a monoclonal antibody directed against IL-33, a pro-inflammatory cytokine that promotes B-class switching to IgE
Summary
Food Allergy (FA) is a pathological and potentially deadly immune response caused by exposure to an innocuous and specific food allergen [1]. The incidence of adverse reactions was significantly lower (2.1% vs 16.1% of doses, p = 0.0005) and those that did occur were less severe in the omalizumab group (2 vs 18 doses requiring epinephrine) [27] These findings were consistent with a study of 14 children aged between 4 months and 11 years affected by egg and cow’s milk allergies. IgG4 could act by inhibiting IgE [29] These data support the role of omalizumab as a viable therapeutic option in patients with FA through raising the threshold tolerance dose, reducing the risk of severe adverse reactions in the case of accidental ingestion [23,24,25,26,27,28,29,31]. The clinical development program for omalizumab as a monotherapy or an adjunctive treatment in FA is summarized in Tables 2 and 3
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