Rewiring Food Allergy Management: From Allergen Detection to Immune Engineering Therapies

BACKGROUND: Food allergy represents a growing global health challenge, particularly among children in developed countries. Despite decades of research, major barriers persist in both allergen detection and durable immune intervention. METHODS: This review synthesizes current diagnostic and therapeutic strategies in food allergy, critically evaluates their mechanistic underpinnings and translational readiness. RESULTS: Traditional immunoassays (e.g. enzyme-linked immunosorbent assay, immunoblotting) are sensitive but hindered by matrix interference, operational complexity, and limited real-world applicability. Recent innovations - multi-omics, DNA-based platforms, and portable biosensors - are advancing allergen surveillance toward precision, on-site detection. In parallel, allergen-specific immunotherapies have emerged as proactive strategies for desensitization, yet vary in efficacy, safety, and sustainability. Biologics (e.g. omalizumab, dupilumab) have broadened treatment options, while next-generation platforms - virus-like particle vaccines and microbiome-augmented protocols - are unlocking novel paths toward sustained unresponsiveness. CONCLUSIONS: This review outlines an emerging framework of immune engineering poised to redefine the future of allergy care.