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British Medical Bulletin 56:925-935 (2000)
© 2000 The British Council

research-article

Food anaphylaxis

Hugh A Sampson, Professor

Pediatrics and Biomedical Sciences, The Mount Sinai School of Medicine, New York, New York, USA

Prof. Hugh A Sampson, Department of Pediatrics Box 1198, The Mount Sinai School of Medicine, One Gustave L Levy Place, New York, NY 10029-6574, USA

Abstract

Food anaphylaxis is now the leading single cause of anaphylactic reactions treated in emergency departments in Westernized countries. In the US, it is estimated that there are 29,000 anaphylactic reactions to foods treated in emergency departments and 125–150 deaths each year. Peanuts, tree nuts, fish and shellfish account for the vast majority of severe food anaphylactic reactions. Immunopathogenic mechanisms responsible for food anaphylaxis may differ somewhat from other forms of anaphylaxis, since elevation of serum tryptase is rarely seen following food anaphylactic reactions. Education regarding the strict avoidance of food allergens, the early recognition of anaphylactic symptoms, and the early use of self-injectable epinephrine remain the mainstays of therapy. However, clinical trials are now underway for the treatment of patients with peanut anaphylaxis utilizing anti-IgE antibody therapy and novel immunomodulatory therapies utilizing ‘engineered’ recombinant prpteins, overlapping peptides, and immunostiuulatory deoxyoligouucleotide sequences are being tested in animal models of anaphylaxis.


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