About this Research Topic
The FDA approved the first therapy for food allergy, Palforzia, in 2020. However, Palforzia, indicated for children 1-18 years of age with peanut allergy, was not favourably received by patients, was not widely prescribed by physicians and failed to significantly change the landscape of food allergy. Fortunately for patients with food allergy, the FDA approved another treatment for food allergy in early 2024, omalizumab. Omalizumab is indicated for all foods and for patients 1 year of age and older, making it the first treatment for adults with food allergy, the first for children 1-4 years of age, and the first for foods beyond peanut. As such, omalmumab has the potential to transform the landscape of food allergy.
Omalizumab, as the first biologic approved for food allergy, also appears to be setting an industry standard for the development of biologics for food allergy. Biologics potently affect fundamental components of the immune system, and can be effective for the treatment of many life-threatening diseases. As such, omalizumab may the first of additional biologics and other therapeutics developed by pharmaceutical companies for food allergy that may further profoundly benefit the lives of food-allergic patients. Over the coming decade, as these new treatments become available, the field of, as well as treatment paradigms for, food allergy could be profoundly changed.
The goals of this article collection are to examine the new treatments that are in the pipeline for food allergy, describe the proposed mechanisms of action, and discuss how such products might improve the symptoms of food allergic patients. We hope to examine/review all of the available mechanistic studies, including safety and efficacy studies in preclinical and clinical trials. The discussion may include the effectiveness of the drug, as well as possible cost-effectiveness analysis, which could determine whether the drug is available in current health care practices (i.e., whether health care payers will approve the therapies for broad use). Our mission will be to look deeply at these new treatments, understand the science and the promise, and consider how each product might change treatment paradigms over time. We expect that over time, newly available effective therapies that are cost effective could transform clinical practice, dramatically affect patient expectations, and disrupt treatment paradigms.
In this Research Topic, we welcome the submission of manuscripts related to the themes described below:
• Pharmaceutical-grade allergen doses for oral immunotherapy, the promise, challenges and controversies.
• Epicutaneous immunotherapy, the promise, challenges and controversies.
• How will omalizumab, once FDA approved (and other anti-IgE mAbs), change the treatment paradigm for food allergy? Who will want treatment, who will get treated, how will treatment be provided, how will it evolve?
• How do microbiome therapies work, will they be effective, how will they be used?
• What new OIT products will be available, particularly for multi-allergic patients?
• What other biologic therapies are in the pipeline: IgGenix food specific IgE mAbs, mast cell-directed and tolerance inducing nano particles, anti-IL-4RA, anti-IL-5 mAbs, abatacept, BTK inhibitors, modified allergens, alternative AIT routes (intralymphatic, sublingual, toothpaste).
• What is the future of personalized treatments in food allergy? Can patient phenotype (sex, age, biomarkers) inform the best choice of treatment?
• What are ongoing initiatives and potential opportunities for drug repurposing in food allergy?
Topic Editor Dale Umetsu is on the Scientific Advisory Board of IgGenix, Food Allergy Science Initiative, AllAdapt, consultant with ASLAN, Triveni, Apogee. Aimmune. Topic Editor Philippe Begin has been an investigator on studies sponsored by Novartis, Sanofi, Regeneron, DBV technologies and ALK, and has received honoraria from Novartis, Sanofi, DBV, ALK, Pfizer and Astra-Zeneca.
Omalizumab, as the first biologic approved for food allergy, also appears to be setting an industry standard for the development of biologics for food allergy. Biologics potently affect fundamental components of the immune system, and can be effective for the treatment of many life-threatening diseases. As such, omalizumab may the first of additional biologics and other therapeutics developed by pharmaceutical companies for food allergy that may further profoundly benefit the lives of food-allergic patients. Over the coming decade, as these new treatments become available, the field of, as well as treatment paradigms for, food allergy could be profoundly changed.
The goals of this article collection are to examine the new treatments that are in the pipeline for food allergy, describe the proposed mechanisms of action, and discuss how such products might improve the symptoms of food allergic patients. We hope to examine/review all of the available mechanistic studies, including safety and efficacy studies in preclinical and clinical trials. The discussion may include the effectiveness of the drug, as well as possible cost-effectiveness analysis, which could determine whether the drug is available in current health care practices (i.e., whether health care payers will approve the therapies for broad use). Our mission will be to look deeply at these new treatments, understand the science and the promise, and consider how each product might change treatment paradigms over time. We expect that over time, newly available effective therapies that are cost effective could transform clinical practice, dramatically affect patient expectations, and disrupt treatment paradigms.
In this Research Topic, we welcome the submission of manuscripts related to the themes described below:
• Pharmaceutical-grade allergen doses for oral immunotherapy, the promise, challenges and controversies.
• Epicutaneous immunotherapy, the promise, challenges and controversies.
• How will omalizumab, once FDA approved (and other anti-IgE mAbs), change the treatment paradigm for food allergy? Who will want treatment, who will get treated, how will treatment be provided, how will it evolve?
• How do microbiome therapies work, will they be effective, how will they be used?
• What new OIT products will be available, particularly for multi-allergic patients?
• What other biologic therapies are in the pipeline: IgGenix food specific IgE mAbs, mast cell-directed and tolerance inducing nano particles, anti-IL-4RA, anti-IL-5 mAbs, abatacept, BTK inhibitors, modified allergens, alternative AIT routes (intralymphatic, sublingual, toothpaste).
• What is the future of personalized treatments in food allergy? Can patient phenotype (sex, age, biomarkers) inform the best choice of treatment?
• What are ongoing initiatives and potential opportunities for drug repurposing in food allergy?
Topic Editor Dale Umetsu is on the Scientific Advisory Board of IgGenix, Food Allergy Science Initiative, AllAdapt, consultant with ASLAN, Triveni, Apogee. Aimmune. Topic Editor Philippe Begin has been an investigator on studies sponsored by Novartis, Sanofi, Regeneron, DBV technologies and ALK, and has received honoraria from Novartis, Sanofi, DBV, ALK, Pfizer and Astra-Zeneca.
Keywords: Food allergy, biologics, OIT, IgE, omalizumab, legalizumab, dupilumab, microbiome therapy, Palforzia, Viaskin, food allergy tolerance, desensitization
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
