Targeting type 2 immunity and the future of food allergy treatment

IgE-mediated food allergy affects 6–8% of the population in the United States. Type 2 immune responses are central to the pathogenesis of food allergy, but type 2 CD4(+) T cell responses have been found to be heterogeneous in food allergy suggesting a division of labor between Tfh13 and peTH2 cells in promotion of IgE class switching, modulation of intestinal barrier function, and regulation of mast cell expansion. Oral immunotherapy for the treatment of food allergy incompletely targets subsets of type 2 immunity in a transient manner, but new therapeutics targeting different levels of type 2 immunity are in current or planned trials for food allergy. These new treatments and the basis for their use are the focus of this review.