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J Allergy Clin Immunol. 2014 Feb;133(2):318-23. doi: 10.1016/j.jaci.2013.12.1040.

State of the art on food allergen immunotherapy: oral, sublingual, and epicutaneous.

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Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark. Electronic address:
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC.
Department of Pediatrics, Paris-Descartes University, Necker Hospital, Paris, France.


IgE-mediated food allergy is a global health problem that affects millions of persons and affects every aspect of life for the patient. Developing effective treatment strategies to augment current practice standards of strict dietary avoidance of antigens and availability of self-injectable epinephrine has been a major focus of research teams, advocacy groups, funding agencies, and patients and their families. Significant progress has been made through the development of allergen-specific immunotherapy encompassing 3 major forms of treatment: oral, sublingual, and epicutaneous immunotherapy. These therapies are in various stages of clinical investigation, with some successes noted in clinical outcomes and modulation of immune mechanisms toward effective therapy. Here we review recent progress and areas of concern for the role of these forms of immunotherapy as an emerging treatment for food allergy.


AE; Adverse event; CoFAR; Consortium of Food Allergy Research; DBPC; Double-blind, placebo-controlled; EPIT; Epicutaneous immunotherapy; Food allergy; OFC; OIT; Oral food challenge; Oral immunotherapy; Regulatory T; SLIT; SPT; Skin prick test; Sublingual immunotherapy; Treg; immunotherapy; investigational; treatment

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