This review highlights some of the research advances in
anaphylaxis and
hypersensitivity reactions to foods, drugs, and insects, as well as advances in allergic
skin disease that were reported in the Journal in 2009. Among key epidemiologic observations, several westernized countries report that more than 1% of children have
peanut allergy, and there is some evidence that environmental exposure to peanut is a risk factor. The role of regulatory T cells,
complement,
platelet-activating factor, and effector cells in the development and expression of
food allergy were explored in several murine models and human studies. Delayed
anaphylaxis to mammalian meats appears to be related to
IgE binding to the
carbohydrate moiety galactose-alpha-1,3-galactose, which also has implications for
hypersensitivity to murine mAb
therapeutics containing this
oligosaccharide. Oral
immunotherapy studies continue to show promise for the treatment of
food allergy, but determining whether the treatment causes tolerance (cure) or temporary desensitization remains to be explored. Increased baseline serum
tryptase levels might inform the risk of
venom anaphylaxis and might indicate a risk for mast cell disorders in persons who have experienced such episodes. Reduced structural and immune barrier function contribute to local and systemic
allergen sensitization in patients with
atopic dermatitis, as well as increased propensity of skin
infections in these patients. The use of increased doses of nonsedating
antihistamines and potential usefulness of
omalizumab for
chronic urticaria was highlighted. These exciting advances reported in the Journal can improve patient care today and provide insights on how we can improve the diagnosis and treatment of these allergic diseases in the future.