This review provides general information to serve as a primer for those embarking on understanding food allergy and also details advances and updates in epidemiology, pathogenesis, diagnosis, and treatment that have occurred over the 4 years since our last comprehensive review. Although firm prevalence data are lacking, there is a strong impression that food allergy has increased, and rates as high as approximately 10% have been documented. Genetic, epigenetic, and environmental risk factors are being elucidated increasingly, creating potential for improved prevention and treatment strategies targeted to those at risk. Insights on pathophysiology reveal a complex interplay of the epithelial barrier, mucosal and systemic immune response, route of exposure, and microbiome among other influences resulting in allergy or tolerance. The diagnosis of food allergy is largely reliant on medical history, tests for sensitization, and oral food challenges, but emerging use of component-resolved diagnostics is improving diagnostic accuracy. Additional novel diagnostics, such as basophil activation tests, determination of epitope binding, DNA methylation signatures, and bioinformatics approaches, will further change the landscape. A number of prevention strategies are under investigation, but early introduction of peanut has been advised as a public health measure based on existing data. Management remains largely based on allergen avoidance, but a panoply of promising treatment strategies are in phase 2 and 3 studies, providing immense hope that better treatment will be imminently and widely available, whereas numerous additional promising treatments are in the preclinical and clinical pipeline.

这篇综述提供了一般信息，可作为那些着手了解食物过敏的入门知识，还详细介绍了自上次全面综述以来四年来流行病学，发病机制，诊断和治疗的进展和更新。尽管缺乏确切的流行率数据，但人们强烈印象是食物过敏有所增加，并且据报道其发病率高达约10％。遗传，表观遗传和环境风险因素正在日益被阐明，这为针对有风险人群的预防和治疗策略创造了潜力。对病理生理学的见解揭示了上皮屏障，粘膜和全身免疫反应，接触途径和微生物组之间复杂的相互作用，导致过敏或耐受性的其他影响。食物过敏的诊断在很大程度上取决于病史，致敏性测试和口服食物挑战，但新兴的使用成分分辨诊断法正在提高诊断准确性。其他新的诊断方法，例如嗜碱性粒细胞活化测试，决定抗原决定簇的结合，DNA甲基化标记和生物信息学方法，将进一步改变这种状况。许多预防策略正在研究中，但是根据现有数据，建议尽早引入花生作为一种公共卫生措施。管理仍主要基于避免过敏原，但是在2期和3期研究中有一大堆有前途的治疗策略，这给人们带来了巨大希望，即即将出现并广泛使用更好的治疗方法，