ALLERGY: Edited by Karen H. CalhounImmunotherapy for food allergyReisacher, William R.a,b; Davison, Wesleya,bAuthor Information aDepartment of Otolaryngology, Head & Neck Surgery, Weill Cornell Medical College bNewYork-Presbyterian Hospital, New York, New York, USA Correspondence to William R. Reisacher, MD, FACS, FAAOA, Associate Professor, Department of Otolaryngology, Head & Neck Surgery, Weill Cornell Medical College, 1305 York Avenue, 5th Floor, New York, NY 10021, USA. Tel: +1 646 962 2093; fax: +1 646 962 0100; e-mail: [email protected] Current Opinion in Otolaryngology & Head and Neck Surgery: June 2017 - Volume 25 - Issue 3 - p 235-241 doi: 10.1097/MOO.0000000000000353 Buy Metrics Abstract Purpose of review The current review discusses strategies for administering specific immunotherapy (SIT) for the treatment of food allergy. It focuses on three delivery routes for food allergens, immunomodulatory adjuvants and allergen modifications. Recent findings Interest in SIT for food allergy has been increasing significantly. Sublingual immunotherapy is effective for desensitization with a very favorable adverse event profile. Epicutaneous immunotherapy is also effective, most notably in younger children, with a high rate of local reactions. Oral immunotherapy demonstrates high efficacy, but with a higher risk of gastrointestinal and systemic adverse events. The need for long-term application to sustain desensitization is currently unclear. Immunomodulatory adjuvants may be added to enhance or diminish the immunogenicity of proteins, whereas genetic modifications of food allergens are designed to limit the risk of adverse reactions and address the issues of standardization and supply. Summary SIT for food allergy is reaching the point where it may soon be used routinely in clinical practice. Current research focuses on new delivery routes and methods to enhance the effectiveness of the therapy while minimizing the risk of adverse reactions. Future efforts are underway to determine the optimal dose for each delivery method and the length of maintenance dosing required to retain the protective effect. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.