Eigenmann, P.A. Future therapeutic options in food allergy. 2003

Allergy has become a major burden in westernized societies during the 20th century, and among allergic manifestations, food allergy accounts for a substantial part of the morbidity rate. Patients with food allergy are handicapped by a strict avoidance diet and a potentially lifelong-lasting disease. Furthermore, in some patients with exquisite food allergy, the risk of fatal reactions is present daily.

Current figures show that up to 5% of young children might suffer from immunoglobulin E (IgE)-mediated food hypersensitivity (1–5). In adults, probably <2% of the population suffers from food allergy (6, 7). In westernized societies, the foods most commonly responsible for allergic reactions are: egg, peanuts, milk, tree nuts, fish, as well as grains, soy and many others, as potentially any food can provoke an IgE-mediated reaction.

A majority of reactions are self-limited, or easily treated with an oral antihistamine treatment and/or injection of adrenaline in potentially life-threatening reactions, but major public concern has increased after reports of fatal allergic reactions caused by foods. Correct numbers of fatalities are hard to determine but projections can help to visualize the size of the problem. In a 4-year time-period community base study in the USA, an anaphylaxis occurrence rate of 30 of 100 000 persons per year was reported, and allergic reactions to foods were the leading identifiable cause of reactions (8). From this data, the number of 29 000 anaphylactic episodes because of food in the USA per year could be extrapolated, with approximately 150 expected deaths per year (9). Reported to the European population this number would be above 200 deaths per year. Knowing that, despite strict avoidance, most food allergic patients carry a high risk of reacting to commercially processed foods contaminated with common food allergens, a pro-active treatment of food allergy is strongly needed (10).