Food hypersensitivity reactions affect up to 8% of children under 3 years of age and approximately 2.5% of the general United States population. Food allergic disorders may be subdivided into either IgE-mediated or cell-mediated reactions. The diagnostic ‘gold standard’ of ‘symptomatic’ food allergies remains the blinded oral food challenge because of the poor specificity of patient histories, skin testing and standard radioallergosorbent tests, and the outcomes of elimination diets. Little progress has been made in the development of in-vitro tests for the diagnosis of cell-mediated food hypersensitivities. However, new developments in in-vitro technologies have improved the capabilities of these tests to diagnose IgE-mediated reactivity and perhaps predict the development of future ‘tolerance’, i.e. ‘outgrowing’ the allergy.
Division of Pediatric Allergy and Immunology, Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, New York, USA
Correspondence to Hugh A. Sampson, MD, Department of Pediatrics, Box 1198, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10538, USA. Tel: +1 212 241 5548; fax: +1 212 426 1902; e-mail: firstname.lastname@example.org