Novel Diagnostics in Food Allergy.

Abstract

Food allergy is increasing in prevalence, and poses significant challenges for individuals and their families, adversely impacting their quality of life. Misdiagnosis can lead to unnecessary dietary and social limitations, and increased food allergy risk, while failure to diagnose may result in life-threatening anaphylaxis. Therefore, a precise diagnosis is of the utmost importance; however, barriers exist at every stage of the diagnostic process. Food allergy diagnosis relies on clinical history, IgE sensitization tests, and oral food challenges. Component testing and identification of optimal cut-offs have improved diagnostic accuracy. Nevertheless, many patients still require oral food challenges and better tests are needed to reduce this. Novel biomarkers, such as the basophil activation test and peptide IgE testing, are transitioning into clinical practice. Future approaches may include alternative biological samples, novel laboratory technologies, and analytical tools, including artificial intelligence, to integrate test results and clinical information. Conscientious use of existing tests, access to tests with superior diagnostic accuracy and combination of tests, can lead to improved precision of food allergy diagnosis and timely introduction of tolerated foods in the diet. This review summarizes recent advances in novel approaches for food allergy diagnosis that can enhance clinical decision-making, now and in the future.