ABSTRACT
During the past half century, allergies of all kinds have become much more common within the developed world. Dietary allergies are no exception, and up to 5% of children develop allergy to cow’s milk and other proteins (reviewed by Walker-Smith and Murch1 and Wood2). There has also been a change in patterns of presentation. As dietary exposures in infancy and early childhood have altered, previously unusual reactions to antigens such as peanut and sesame have become much more common.3-5 There are important geographical differences, with different incidence of specific allergies varying from country to country.5 This may relate to genetic differences in immune responses amongst different ethnic groups, or to local dietary customs – exemplified most strikingly by reports of anaphylaxis to birds’ nest soup in Singaporean infants.6 However, a broader context is provided by recent evidence from the direction of basic science, which highlights the importance of infectious exposures of the innate immune system in early life in inducing tolerance to dietary antigens (oral tolerance). This chapter attempts to encompass both the clinical
aspects of food allergy and some of the relevant scientific background.
