MINI REVIEW article
Front. Allergy
Sec. Food Allergy
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1578601
This article is part of the Research TopicPrediction of Severity of Food AllergyView all articles
Prediction of Food Allergy Reaction Severity: Biomarkers and Host Factors
Provisionally accepted- Allergy Partners of Chapel Hill, Chapel Hill, United States
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Prediction of food allergy reaction severity remains a challenging clinical dilemma, with no single biomarker or patient factor serving as a definitive predictor. This mini-review explores advancements in two key domains: biomarkers and host factors. Biomarker studies highlight the predictive limitations of IgE sensitization levels, while emerging tools such as basophil activation tests (BAT) and bead-based epitope assays (BBEA) are promising but are not yet in widespread use. Specifically, BAT demonstrates superior discriminatory power for severe peanut and baked egg reactions, whereas Arah2 component level above 1.4 kU/L suggest a more severe peanut allergy phenotype.Host factors, including comorbid conditions, age, and behavioral variables, further complicate severity prediction. While asthma has frequently been assumed to be involved in more severe reactions, recent meta-analyses refute this association unless asthma is poorly controlled. Similarly, a history of anaphylaxis does not reliably predict future reaction severity. Age emerges as a significant variable, with adolescents through the fourth decade of life displaying a higher risk for severe reactions. Additionally, cofactors such as exercise, alcohol, and certain medications may modulate reaction severity, albeit with varying degrees of evidence. Despite these advances, significant knowledge gaps remain in predicting reaction severity with high confidence. The future likely lies in a multifactorial approach. Understanding the interplay of biomarkers and host factors will be crucial in developing more accurate predictive models, ultimately enhancing food allergy management and patient safety.
Keywords: Anaphylaxis, basophil activating test (BAT), food allergy severity, biomarkers, component resolved allergy diagnostics, Predition Model
Received: 17 Feb 2025; Accepted: 03 Jun 2025.
Copyright: © 2025 Fitzhugh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: David Fitzhugh, Allergy Partners of Chapel Hill, Chapel Hill, United States
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