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Applied Sciences
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New Diagnostic and Therapeutic Approaches in Food Allergy
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New Diagnostic and Therapeutic Approaches in Food Allergy

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: 30 October 2025 | Viewed by 12824

Special Issue Editors

Dr. José Antonio Canas

E-Mail Website
Guest Editor
Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
Interests: asthma; food allergy; microRNAs; exosomes
Special Issues, Collections and Topics in MDPI journals
Dr. Blanca Cárdaba

E-Mail Website
Guest Editor
Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
Interests: asthma; system biology; allergic biomarkers
Special Issues, Collections and Topics in MDPI journals
Dr. Rubén Fernández-Santamaría

E-Mail Website
Guest Editor
Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
Interests: asthma; drug allergy; dendritic cell; basophil activation test

Special Issue Information

Dear Colleagues,

Food allergy is an adverse reaction of the immune system triggered by harmless food-derived allergens. In recent years, the incidence of these allergic disorders has increased, becoming a serious social and economic burden worldwide. Although various studies and guidelines have emphasized that food allergies are more common in children than in adults, they can cause mild to severe symptoms in both groups and can sometimes be life-threatening. Therefore, diagnosis and treatment are crucial in order to avoid food allergy reactions.

This Special Issue welcomes submissions of Original Research Articles, Clinical Case Reports and Reviews on novel studies performed in the diagnosis and treatment of food allergies. Specific subject areas of interest include, but are not limited to, the following:

  • Specific mechanisms of food allergy (cellular and molecular).
  • Current clinical tips on food allergy diagnosis.
  • Novel methods on food allergy diagnosis.
  • Cellular and molecular biomarkers of food allergy.
  • The role in food tolerance acquisition.
  • Involvement of dendritic cells, T regulatory cells and innate lymphoid cells in food allergy mechanisms.
  • New perspectives of allergen immunotherapy.
  • New approaches to desensitization in food allergy.
  • Monoclonal antibody therapies in food allergy treatment.
  • Clinical implications of food–pollen crossreactivity.
  • Genetic and epigenetic in food allergy.

Dr. José Antonio Canas
Dr. Blanca Cárdaba
Dr. Rubén Fernández-Santamaría
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • food allergy
  • T2 response
  • IgE-mediated mechanisms
  • basophil activation test
  • immunotherapy

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Published Papers (7 papers)

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Research

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17 pages, 1730 KiB  
Article
Fenugreek: New Therapeutic Resource or Emerging Allergen?
by Clara Alessandrello, Serena Sanfilippo, Sebastiano Gangemi, Giovanni Pioggia and Paola Lucia Minciullo
Appl. Sci. 2024, 14(20), 9195; https://doi.org/10.3390/app14209195 - 10 Oct 2024
Cited by 1 | Viewed by 5361
Abstract
Background: Fenugreek, or Trigonella foenum greacum, is an ancient medicinal plant native to the eastern Mediterranean that later spread to Asia; it is used as a medicinal herb, spice, or food. It is a component of spice mixes, such as curry, and [...] Read more.
Background: Fenugreek, or Trigonella foenum greacum, is an ancient medicinal plant native to the eastern Mediterranean that later spread to Asia; it is used as a medicinal herb, spice, or food. It is a component of spice mixes, such as curry, and it is also used as a supplement in wheat and corn flour for bread making. Fenugreek appears to have many health benefits and potential medicinal properties; for this reason, it is increasingly being used in nutraceutical formulations. This study aimed to describe patients who visited our operative unit for a suspected adverse reaction after ingestion of fenugreek and to highlight possible cross-reactivity between fenugreek and other legumes or other foods. Methods: A total of 13 patients (5 males and 8 females; mean age: 30.6; range: 20–42 years) visited our outpatient clinic with a clinical history suggestive of an allergic reaction to spices or legumes. They underwent a skin prick test for fenugreek, fresh foods, and food extracts. Results: A total of 6 out of 13 patients positive for fenugreek had experienced allergic symptoms after ingesting foods containing spices, and 10 patients presented polysensitization with other legumes, of which 8 also presented sensitization to pistachios. Conclusions: Given the increasing use of novel spices in Mediterranean cuisine and the possible spread of fenugreek-based nutraceuticals, it is relevant to draw attention to possible allergic reactions. Further studies are also needed to be able to establish its cross-reactivity pattern. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Approaches in Food Allergy)
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Review

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25 pages, 479 KiB  
Review
Improving Safety in Food Allergen-Specific Oral Immunotherapy
by Iva Mrkić Kobal, Milan Jurić, Helena Munivrana Škvorc, Adrijana Miletić Gospić, Andrija Miculinić and Davor Plavec
Appl. Sci. 2025, 15(9), 4857; https://doi.org/10.3390/app15094857 - 27 Apr 2025
Viewed by 296
Abstract
Food allergies are becoming more common globally. The strict elimination diet, as the main approach so far, has a negative impact on different areas of the lives of children suffering from food allergies, as well as on their caregivers. Oral immunotherapy (OIT), which [...] Read more.
Food allergies are becoming more common globally. The strict elimination diet, as the main approach so far, has a negative impact on different areas of the lives of children suffering from food allergies, as well as on their caregivers. Oral immunotherapy (OIT), which consists of ingesting small, gradually increasing amounts of food allergens, is a promising approach. Although efficient, this approach is accompanied by frequent adverse reactions (AR), some of which are as severe as anaphylaxis. It seems that, generally, slow dose escalation, as well as low maintenance doses with longer durations, make OIT safer, especially in children with severe food allergies. Furthermore, less allergenic forms of allergens, such as baked milk or egg, also contribute to OIT safety. Adjuvant therapy in combination with OIT has the potential to improve OIT efficiency and safety. Treatment with monoclonal antibodies such as omalizumab and dupilumab in combination with OIT is promising. While both could improve efficiency, omalizumab seems to have a better effect on safety. Interferon γ shows promising results. In contrast, the effect of probiotics and vitamin D supplementation in combination with OIT is still controversial, and new trials about their synergistic effect are needed. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Approaches in Food Allergy)
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11 pages, 1485 KiB  
Review
Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
by Edoardo Cavaglià, Guido Maria Valentini, Nicolò Valli, Giovanni Paoletti, Mattia Giovannini, Pasquale Comberiati, Alessandro Fiocchi, Alfredo Scardini, Maria Rita Messina, Giorgio Walter Canonica, Enrico Heffler and Antonio Bognanni
Appl. Sci. 2025, 15(9), 4833; https://doi.org/10.3390/app15094833 - 27 Apr 2025
Viewed by 376
Abstract
Peanut allergy is a persistent and potentially life-threatening condition affecting millions worldwide, necessitating effective therapeutic strategies beyond strict avoidance. Oral immunotherapy (OIT) has emerged as a promising approach, with peanut (Arachis hypogaea) allergen powder dnfp (Palforzia Aimmune therapeutics Brisbane Calif]) being [...] Read more.
Peanut allergy is a persistent and potentially life-threatening condition affecting millions worldwide, necessitating effective therapeutic strategies beyond strict avoidance. Oral immunotherapy (OIT) has emerged as a promising approach, with peanut (Arachis hypogaea) allergen powder dnfp (Palforzia Aimmune therapeutics Brisbane Calif]) being the first FDA-approved standardized OIT for peanut allergy. This review synthesizes current clinical evidence on PTAH (peanut-tolerant Arachis hypogea), focusing on its efficacy, safety, and long-term outcomes. A systematic literature search was conducted, analyzing key phase 3 trials, including PALISADE, ARTEMIS, and POSEIDON, as well as long-term extension studies such as ARC004 and ARC008. Findings indicate that PTAH significantly increases the peanut protein threshold tolerated by allergic individuals, reducing the risk of severe reactions upon accidental exposure. While adverse events such as gastrointestinal symptoms and anaphylaxis occur, they are generally manageable and decline over time with continued therapy. Notably, younger children in the POSEIDON trial exhibited higher desensitization rates, suggesting the potential benefits of early intervention. Long-term studies demonstrate sustained immune modulation, with reductions in peanut-specific IgE and an increase in IgG4, indicative of developing tolerance. Despite limitations such as adherence challenges and the need for ongoing maintenance dosing, PTAH represents a paradigm shift in peanut allergy management, offering improved safety and quality of life for patients and caregivers. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Approaches in Food Allergy)
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17 pages, 1124 KiB  
Review
Pollen Food Allergy Syndrome in Southern European Adults: Patterns and Insights
by Christina Rousou, Egor Kostin, Eleni Christodoulou, Theodoros Theodorou, Zenon Pavlou and Constantinos Pitsios
Appl. Sci. 2025, 15(7), 3943; https://doi.org/10.3390/app15073943 - 3 Apr 2025
Viewed by 525
Abstract
Oral Allergy Syndrome (OAS) is an allergic reaction that occurs upon contact of the mouth and throat with food, leading to symptoms primarily affecting the oral mucosa. In patients with allergic rhinitis, OAS may develop due to cross-reactivity between the pollen allergens responsible [...] Read more.
Oral Allergy Syndrome (OAS) is an allergic reaction that occurs upon contact of the mouth and throat with food, leading to symptoms primarily affecting the oral mucosa. In patients with allergic rhinitis, OAS may develop due to cross-reactivity between the pollen allergens responsible for allergic rhinitis, and specific plant-derived foods. This particular type of OAS is known as Pollen Food Allergy Syndrome (PFAS). The difference in prevalence of PFAS across different regions of the world is attributed to various factors, including environmental exposure and dietary habits. Southern Europe’s temperate climate favors the blooming of many allergenic plants, making respiratory allergies and PFAS significant public health concerns. There is a regional variation in pollen in Southern Europe, contributing to differences in the presence of panallergens—such as profilins, pathogenesis-related class 10 (PR-10) proteins and lipid transfer proteins (LTPs)—which mediate PFAS. In order to examine the epidemiology, pathogenesis, and diagnostic approaches of OAS and PFAS, focusing on their prevalence and impact in Southern European adults, a narrative review was performed. Data from Portugal, Spain, France, Italy, Albania, Greece, and Türkiye were retrieved. The main outcome of this review was that the frequency of PFAS varies across studies, not only between countries but also within the same country, due to vegetation variability across regions as well as methodological differences and the year of study. However, despite these differences, PFAS emerges as a common issue in Southern Europe, underscoring the need for effective diagnosis and management. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Approaches in Food Allergy)
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15 pages, 487 KiB  
Review
Is IBS a Food Allergy? Confocal Laser Endomicroscopy Findings in Patients with IBS: A Narrative Review
by Francesco Pavan, Andrea Costantino, Gian Eugenio Tontini, Luca Elli, Nicola Siragusa, Giovanni Lasagni, Marco Dubini, Alice Scricciolo and Maurizio Vecchi
Appl. Sci. 2025, 15(7), 3717; https://doi.org/10.3390/app15073717 - 28 Mar 2025
Viewed by 519
Abstract
Irritable bowel syndrome (IBS) is a gut–brain interaction disorder often associated with food-related triggers, yet the efficacy of common exclusion diets remains debated. Confocal laser endomicroscopy (CLE) offers real-time, high-resolution imaging of intestinal mucosal changes, allowing the visualization of food-induced barrier dysfunction. Early [...] Read more.
Irritable bowel syndrome (IBS) is a gut–brain interaction disorder often associated with food-related triggers, yet the efficacy of common exclusion diets remains debated. Confocal laser endomicroscopy (CLE) offers real-time, high-resolution imaging of intestinal mucosal changes, allowing the visualization of food-induced barrier dysfunction. Early evidence indicates that a substantial subset of IBS patients exhibit acute mucosal reactions to specific foods, identified as fluorescein leakage and cell shedding on CLE, with over 70% showing symptom improvements after tailored exclusion diets. These findings suggest that localized immune responses and barrier defects may contribute to IBS symptoms beyond IgE-driven immunologic mechanisms. However, most CLE-based studies are small, unblinded, and heterogeneous, limiting definitive conclusions. Further research is needed to validate the diagnostic accuracy of CLE, refine protocols, and clarify how best to integrate CLE into personalized dietary management for difficult-to-treat IBS. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Approaches in Food Allergy)
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46 pages, 2851 KiB  
Review
Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges
by Laura Haidar, Camelia Felicia Bănărescu, Cristina Uța, Sandra Iulia Moldovan, Elena-Larisa Zimbru, Răzvan-Ionuț Zimbru, Elena Ciurariu, Marius Georgescu and Carmen Panaitescu
Appl. Sci. 2025, 15(1), 66; https://doi.org/10.3390/app15010066 - 25 Dec 2024
Cited by 2 | Viewed by 2415
Abstract
Pollen–food allergy syndrome (PFAS), also known as oral allergy syndrome, is a common condition affecting individuals sensitized to pollens such as birch, ragweed, and grass. This syndrome arises from immunological cross-reactivity between pollen allergens and structurally similar proteins found in various fruits, vegetables, [...] Read more.
Pollen–food allergy syndrome (PFAS), also known as oral allergy syndrome, is a common condition affecting individuals sensitized to pollens such as birch, ragweed, and grass. This syndrome arises from immunological cross-reactivity between pollen allergens and structurally similar proteins found in various fruits, vegetables, and nuts. Although typically presenting with mild oral and pharyngeal symptoms, PFAS can occasionally result in severe allergic reactions, underscoring its clinical significance. This review explores the pathophysiology of PFAS, highlighting the molecular mechanisms underlying cross-reactivity and examining the main protein families involved, including those contributing to variations in symptom severity. Current diagnostic approaches, including skin prick testing, specific immunoglobulin E measurements, and component-resolved diagnostics, are discussed. Emerging diagnostic tools and biomarkers with potential to enhance accuracy are also examined. Therapeutic strategies for PFAS primarily focus on symptom management and avoidance of trigger foods. However, novel approaches such as allergen immunotherapy and biologics targeting key immune pathways are gaining traction as potential interventions for more severe or refractory cases. By addressing the diagnostic and therapeutic challenges of PFAS, this paper aims to provide clinicians and researchers with a comprehensive understanding of this condition, fostering improved patient care and the development of innovative treatment strategies. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Approaches in Food Allergy)
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Other

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18 pages, 837 KiB  
Systematic Review
Impact of Childhood Food Allergy on Quality of Life: A Systematic Review
by Selene Valero-Moreno, Rocío Torres-Llanos and Marián Pérez-Marín
Appl. Sci. 2024, 14(23), 10989; https://doi.org/10.3390/app142310989 - 26 Nov 2024
Cited by 2 | Viewed by 2168
Abstract
Background: Food allergy is the third most commonly diagnosed allergic disorder in children, particularly during infancy and preschool years. Its prevalence has been rising rapidly in recent years, making it a significant public health concern. This study aims to conduct a systematic review [...] Read more.
Background: Food allergy is the third most commonly diagnosed allergic disorder in children, particularly during infancy and preschool years. Its prevalence has been rising rapidly in recent years, making it a significant public health concern. This study aims to conduct a systematic review of the impact of childhood food allergies on quality of life. Methods: A comprehensive search of databases from the last five years was conducted following the PRISMA guidelines, resulting in the selection of 21 relevant articles. Results: The findings indicate that food allergies significantly reduce children’s quality of life, with age, the number of allergens, and allergy severity being key determinants. Affected children experience higher levels of anxiety, depression, and reduced psychosocial functioning. Caregivers also face substantial burdens, including constant concerns over accidental exposure, limitations in social activities, financial strain, and increased work absences. In school settings, these children are more prone to teasing or bullying, highlighting the need for increased education and social awareness. Conclusions: Food allergies significantly impact the quality of life for both patients and their families, especially mothers, with worsening effects as children age, including heightened risks of bullying and social limitations, highlighting the need for education, psychological support, and resource allocation. Full article
(This article belongs to the Special Issue New Diagnostic and Therapeutic Approaches in Food Allergy)
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