Scott H. Sicherer - The Complete Guide to Food Allergies in Adults and Children: TREATMENTS for Food Allergy

The Complete Guide to
Food Allergies
in Adults and Children

A Johns Hopkins Press Health Book

JOHNS HOPKINS UNIVERSITY PRESS
Baltimore

Note to the Reader: This book is not meant to substitute for medical care, and treatment should not be based solely on its contents. Instead, treatment must be developed in a dialogue between the individual and their physician. Our book has been written to help with that dialogue.

Drug dosage: The author and publisher have made reasonable efforts to determine that the selection of drugs discussed in this text conform to the practices of the general medical community. The medications described do not necessarily have specific approval by the US Food and Drug Administration for use in the diseases for which they are recommended. In view of ongoing research, changes in governmental regulation, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert of each drug for any change in indications and dosage and for warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently used drug.

2022 Scott H. Sicherer, MD

All rights reserved. Published 2022

Printed in the United States of America on acid-free paper

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Johns Hopkins University Press

2715 North Charles Street

Baltimore, Maryland 21218-4363

www.press.jhu.edu

Library of Congress Cataloging-in-Publication Data

Names: Sicherer, Scott H., author.

Title: The complete guide to food allergies in adults and children / Scott H. Sicherer, MD.

Description: Baltimore : Johns Hopkins University Press, 2022. | Series: A Johns Hopkins press health book | Includes index.

Identifiers: LCCN 2021017979 | ISBN 9781421443164 (hardcover) | ISBN 9781421443157 (paperback) | ISBN 9781421443164 (ebook)

Subjects: LCSH: Food allergy. | Food allergy in children. | Food allergyTreatment. | Food allergyPrevention. | Self-care, Health.

Classification: LCC RC596 .S378 2022 | DDC 616.97/5dc23

LC record available at https://lccn.loc.gov/2021017979

A catalog record for this book is available from the British Library.

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This book is dedicated to people with food allergies and those who care for them. It is the result of thousands of questions I have been asked by adults and children with food allergies; parents of children with food allergies; as well as allergists, medical students, physicians in training, pediatricians, the media, government officials, researchers, teachers, school nurses, and others. Your questions have led me at times to seek answers from you as well as from others, from research, and through trial and error. It is my pleasure and privilege to present this book, which is designed to give you what you have asked for: a place to find accurate, timely, detailed, and helpful answers to questions on every aspect of food allergies.

I marvel at the amazing strides I have witnessed in the diagnosis, prevention, and treatment of food allergies, particularly over the past five years. We now have tests that are better at diagnosing a true allergy, and even better ones are on the way. We have gained insights on how food allergy can be prevented, with a clear approach for peanut, and are in the midst of multiple studies on preventing other food allergies. The first therapy for food allergy approved by the US Food and Drug Administration, a peanut oral immunotherapy product, has come into practice. In parallel, oral immunotherapy approaches to other foods are under study and are also being used in many practices. Numerous exciting novel approaches are also under study, with increasingly better safety and efficacy. In this book, I explore all of these areas to help you make informed decisions. While the emerging therapies are presenting some difficult choices, they also offer a remarkable number of options to treat food allergy and improve quality of life. It is hard for me to imagine, based on what I see in this field, that we will be doing what we are doing now in another five or ten years. I feel confident in telling my young patients that when they are adults, they may not need to avoid the foods they are allergic to today. Although most of the approaches that are emerging are not a simple cure, I have strong hope that we will get there.

This book would not exist were it not for the work and influences of many people, and so I dedicate this book to the many who have taught me over the years, including Hugh A. Sampson, MD; Sally Noone, RN; Marion Groetch, RD; and Robert A. Wood, MD. It is also dedicated to my many colleagues at Mount Sinais Jaffe Food Allergy Institute, and researchers and colleagues worldwide. I want to thank the National Institute of Allergy and Infectious Diseases and Food Allergy Research & Education for supporting my research. I thank the Jaffe family for their foresight in establishing a food allergy institute at Mount Sinai in New York, and also the many families and visionary philanthropists for supporting our research and clinical care initiatives. Most importantly, I thank the children, adults, and families who have altruistically contributed to our understanding of food allergy by their participation in research studiesthey are absolutely the heroes who will help us to cure this disease. Finally, I thank my wife, Mati, and children, Andrew, Zachary, Maya, Sydnee, and Cassaddee... for everything.

Hugh A. Sampson, MD

Emeritus Director, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York

Over the past four decades, I have been fortunate to witness and participate in a remarkable evolution in our understanding of food allergies. When I began my food allergy research in the early 1980s, I approached the disorder by applying my background in detailed scientific methods. Although a bit reluctant and highly skeptical, I was encouraged to explore this area by Dr. Susan Dees, an emeritus professor and a wonderful mentor during my early years at Duke University. Then my own fascination with the field grew as a result of experiences with my second daughter, who had food allergies, eczema, and later asthma, and as I cared for an increasing number of families and children with food allergy symptoms in my clinical practice. In those early years, I was reluctant to admit to my colleagues that I was focusing my research on food allergy. The reason for my trepidation was that food allergy, in those early days, was considered not a real disease but a problem of little consequence. Part of the reason for this misperception was that many people were attributing various problems to foods that were never proven to be involved using scientifically validated methods. At the same time, people were not recognizing allergic diseases that actually were caused or worsened by foods. Although everyone acknowledged that a food could cause a severe allergic reaction, the life-threatening nature of this allergy was not well appreciated.