Evolution of Treating Allergies; Out with Avoidance, In With Early Exposure
DOI:
https://doi.org/10.33178/SMJ.2026.6Keywords:
food allergy, oral immunotherapy, paediatric allergy, safe bite, anaphylaxisAbstract
Abstract
Traditionally, paediatric food allergy management has relied on strict allergen avoidance as the primary strategy to minimize anaphylaxis. However, evidence suggests that prolonged avoidance may increase sensitization and allergy severity. Immunological advances have prompted a shift towards early allergen introduction. This review compares strict food avoidance and oral immunotherapy (OIT), highlighting both the advantages and disadvantages. Current evidence suggests that early allergen introduction significantly reduces allergy development and increases reaction thresholds, thereby providing protection against future accidental exposure. However, sustained remission is limited, and an increased risk of certain long-term adverse conditions has been observed. Even so, OIT represents a shift from avoidance towards risk modification.
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Copyright (c) 2026 Anna Feore, Corissa Larson, Nicole Crellin-Parsons, Hannah Griffin, Tanmya Sharma, Rhea Mital, Carina Lam, Keshanah Raviendran
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