The Journal of allergy and clinical immunology
July 24, 2026 · via Europe PMC
International perspective on obtaining disease modification with food allergy therapies.
Anagnostou A, Bégin P, Eiwegger T, Greenhawt M, Mack DP, Togias A.
AI summary — for doctors, generated from the abstract only
Food allergy immunotherapies often achieve desensitization and sometimes sustained unresponsiveness or remission, but there is no consensus definition of disease modification and no validated biomarkers.
What was studied
An international expert-opinion review of definitions (desensitization, sustained unresponsiveness, tolerance, remission) and evidence for disease-modifying effects of oral, epicutaneous and sublingual immunotherapy and biologics.
Key findings
- Desensitization is common with oral, epicutaneous and sublingual immunotherapy, and a subset achieves sustained unresponsiveness or remission after stopping
- Younger age and lower baseline allergen-specific IgE may predict more durable responses
- Approved biologics enhance protection during treatment but have limited evidence for direct disease modification
Clinical relevance
Clinicians and families should understand that protection during treatment is not the same as lasting change, and the review supports using consistent terminology.
Who should care
Limitations
Expert opinion and narrative synthesis without quantitative data in the abstract; the authors note no consensus definition and no biomarkers.
Disease modification in food allergy is plausible for some patients, yet definitions and biomarkers are still lacking.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
A disease-modifying therapy aims to alter natural history by delaying or reversing disease progression.
Objective
We examined expert opinion regarding the concept of disease modification in food allergy to assess consensus, definitions, and identification of relevant biomarkers.
Methods
We contextualized relevant definitions to terms such as desensitization, sustained unresponsiveness, tolerance, and remission; and evaluated evidence-based disease-modifying effects of therapeutic strategies.
Results
Evidence from oral, epicutaneous and sublingual immunotherapy demonstrates that desensitization is common and that a subset of patients has disease with sustained unresponsiveness or remission after treatment discontinuation. Younger age and lower baseline allergen-specific IgE may predict more durable responses. Immunologic changes associated with these outcomes include suppression of type 2 cellular responses, modulation of B-cell compartments, and induction of blocking antibodies. Currently approved biologics enhance protection during active treatment but have limited evidence for direct disease modification, although they may facilitate tolerance when combined with allergen exposure.
Conclusions
While the clinical states of desensitization, sustained unresponsiveness, tolerance, and remission may involve partial or complete disease modification in food allergy, no consensus definition exists, and no relevant biomarkers have been identified to date.
DOI
10.1016/j.jaci.2026.07.007
PMID
42498123
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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