Biologics in food allergy: up-to-date

ABSTRACT

Introduction: In recent years, the advent of immunotherapy has remarkably improved the management of IgE-mediated food allergy. However, some barriers still exist. Therefore, the effort of researchers aims to investigate new perspectives in the field of non-allergen specific therapy, also based on the current knowledge of the pathogenesis of this disease.

Areas covered: This review aims to focus on the role of biologics as a treatment option in patients with IgE-mediated food allergy. These agents are characterized by their ability to inactivate the Th2 pro-inflammatory pathways. Biologics can be used both alone and in association with immunotherapy. Monoclonal antibodies targeting IgE, the IL-4/IL-13 axis, IL-5, and alarmins have been proposed and investigated for treating food allergy.

Expert opinion: The clinical efficacy and safety of biologics have been demonstrated in several preclinical studies and randomized controlled trials. Future studies are still required to address current unmet needs, including the identification of the optimal dose to be used by ensuring the effectiveness of therapy.

KEYWORDS:

• Alarmins
• dupilumab
• etokimab
• ige-mediated food allergy
• immunotherapy
• mepolizumab
• omalizumab
• pathogenesis
• reslizumab

Article highlights

• In the last decade, several studies have been conducted to evaluate the use of biologics in the management of food allergy.

• Omalizumab, used in association with immunotherapy, has been demonstrated to be safe and effective to achieve rapid desensitization.

• The dose-related efficacy of Omalizumab-enabled immunotherapy is currently one of the most relevant unresolved issues.

• Several ongoing studies are testing the potential therapeutic role of biologics targeting the IL-4/IL-13 axis, IL-5, and other cytokines.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.