The prevalence of food allergy (FA) has increased too rapidly, possibly due to environmental factors. The guidelines recommend strict allergen avoidance, but FA is still the main cause of anaphylaxis in all age groups. Immunotherapy is the only treatment able to change the course of allergic disease, and oral immunotherapy (OIT) is the more effective route in FA. However, it carries the risk of adverse reactions, including anaphylaxis. To improve OIT safety, adjuvant therapy with the immunoglobulin E (IgE) monoclonal antibody omalizumab has been extensively used. Results suggest particular benefit in patients with high risk of fatal anaphylaxis. An alternative approach is to use omalizumab instead of OIT to prevent severe allergic reactions upon accidental exposure. This paper reviews current evidence regarding IgE-mediated FA, focusing on natural tolerance and food sensitization acquisition, and on avoidance measures and their limitations.

中文翻译：

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食物过敏-从避免食物到积极治疗。

食物过敏（FA）的患病率增长过快，可能是由于环境因素所致。该指南建议严格避免过敏原，但FA仍然是所有年龄段过敏的主要原因。免疫疗法是唯一能够改变过敏性疾病进程的疗法，而口服免疫疗法（OIT）是FA中更有效的途径。但是，它具有不良反应的风险，包括过敏反应。为了提高OIT安全性，已广泛使用免疫球蛋白E（IgE）单克隆抗体omalizumab的辅助治疗。结果表明，对致命致死风险高的患者特别有益。另一种方法是使用奥马珠单抗代替OIT，以防止意外接触时发生严重的过敏反应。本文回顾了有关IgE介导的FA的最新证据，