Non-immunoglobulin E-mediated food allergy

Abstract Non-immunoglobulin E (IgE)-mediated food allergies are characterized by delayed gastrointestinal (GI) manifestations that occur after exposure to an inciting food protein; they include food protein-induced allergic proctocolitis (FPIAP), food protein–induced enteropathy (FPE), and food prot...

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Main Authors: Victoria E. Cook, Lori A. Connors, Timothy K. Vander Leek, Wade Watson
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Allergy, Asthma & Clinical Immunology
Online Access:https://doi.org/10.1186/s13223-024-00933-4
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author Victoria E. Cook
Lori A. Connors
Timothy K. Vander Leek
Wade Watson
author_facet Victoria E. Cook
Lori A. Connors
Timothy K. Vander Leek
Wade Watson
author_sort Victoria E. Cook
collection DOAJ
description Abstract Non-immunoglobulin E (IgE)-mediated food allergies are characterized by delayed gastrointestinal (GI) manifestations that occur after exposure to an inciting food protein; they include food protein-induced allergic proctocolitis (FPIAP), food protein–induced enteropathy (FPE), and food protein-induced enterocolitis syndrome (FPIES). Although the exact mechanisms underlying these disorders are not well understood, non-IgE-mediated food allergies likely represent a spectrum of disease with shared pathophysiological processes. Typically, these non-IgE-mediated food allergies begin in infancy or early childhood, although FPIES can present across the lifespan, with increasing reports in adults in recent years. Diagnosing non-IgE-mediated food allergies can be challenging due to the lack of noninvasive confirmatory tests or biomarkers for most of these disorders and the non-specific nature of GI symptoms. Thus, the diagnosis is usually made clinically, and relies on a constellation of typical symptoms that improve upon removal of the culprit food. The primary approach to management of FPIAP, FPE and FPIES is avoidance of the triggering food, and a multidisciplinary management approach that includes allergy/immunology may be required to avoid unnecessary food restriction and guide food reintroduction. This review outlines the clinical manifestations, epidemiology, pathophysiology, diagnosis, management, and prognosis of these non-IgE-mediated food allergies.
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spelling doaj-art-d0abb5c5089f45208e6f942ba40133872024-12-22T12:32:01ZengBMCAllergy, Asthma & Clinical Immunology1710-14922024-12-0120S311810.1186/s13223-024-00933-4Non-immunoglobulin E-mediated food allergyVictoria E. Cook0Lori A. Connors1Timothy K. Vander Leek2Wade Watson3Division of Allergy, Department of Pediatrics, University of British ColumbiaDepartment of Medicine, Dalhousie UniversityDivision of Allergy, Department of Pediatrics, University of British ColumbiaDivision of Allergy, Department of Pediatrics, Dalhousie University, IWK Health CentreAbstract Non-immunoglobulin E (IgE)-mediated food allergies are characterized by delayed gastrointestinal (GI) manifestations that occur after exposure to an inciting food protein; they include food protein-induced allergic proctocolitis (FPIAP), food protein–induced enteropathy (FPE), and food protein-induced enterocolitis syndrome (FPIES). Although the exact mechanisms underlying these disorders are not well understood, non-IgE-mediated food allergies likely represent a spectrum of disease with shared pathophysiological processes. Typically, these non-IgE-mediated food allergies begin in infancy or early childhood, although FPIES can present across the lifespan, with increasing reports in adults in recent years. Diagnosing non-IgE-mediated food allergies can be challenging due to the lack of noninvasive confirmatory tests or biomarkers for most of these disorders and the non-specific nature of GI symptoms. Thus, the diagnosis is usually made clinically, and relies on a constellation of typical symptoms that improve upon removal of the culprit food. The primary approach to management of FPIAP, FPE and FPIES is avoidance of the triggering food, and a multidisciplinary management approach that includes allergy/immunology may be required to avoid unnecessary food restriction and guide food reintroduction. This review outlines the clinical manifestations, epidemiology, pathophysiology, diagnosis, management, and prognosis of these non-IgE-mediated food allergies.https://doi.org/10.1186/s13223-024-00933-4
spellingShingle Victoria E. Cook
Lori A. Connors
Timothy K. Vander Leek
Wade Watson
Non-immunoglobulin E-mediated food allergy
Allergy, Asthma & Clinical Immunology
title Non-immunoglobulin E-mediated food allergy
title_full Non-immunoglobulin E-mediated food allergy
title_fullStr Non-immunoglobulin E-mediated food allergy
title_full_unstemmed Non-immunoglobulin E-mediated food allergy
title_short Non-immunoglobulin E-mediated food allergy
title_sort non immunoglobulin e mediated food allergy
url https://doi.org/10.1186/s13223-024-00933-4
work_keys_str_mv AT victoriaecook nonimmunoglobulinemediatedfoodallergy
AT loriaconnors nonimmunoglobulinemediatedfoodallergy
AT timothykvanderleek nonimmunoglobulinemediatedfoodallergy
AT wadewatson nonimmunoglobulinemediatedfoodallergy