2021 Volume 35 Issue 1 Pages 77-84
A shift in the treatment of food allergy has occurred from elimination of the causative foods to oral immunotherapy; however, the issue of treatment safety has been raised. Although there is no doubt that oral immunotherapy is beneficial for patients with persistent food allergy, many issues, such as the risk of inducing symptoms and unknown long-term prognosis, remain unresolved. Further, oral immunotherapy is not recommended for general practice at present.
To ensure the safety of treatment, correct diagnosis, and assessment of its severity, appropriate oral food challenge, determination of indications for treatment, and proper knowledge of food allergy are essential. Adjusting the target dose and dose escalation speed, modifying the administration routes (sublingual immunotherapy, epicutaneous immunotherapy), standardization of antigens, usage of low-allergenic foods, and combination therapy with anti-human immunoglobulin E antibody are being considered for further improvement of the safety of oral immunotherapy. It is also necessary to establish an emergency system and reinforce regional healthcare coordination under the concept of food allergies being cured in the community.
