Ruchi S. Gupta, MD, MPH, Editor

Although research on treatments has advanced, there is still no publicly available treatment or cure for food allergy. The first step in management is avoidance of the allergenic food. For many families, avoiding the allergen is complex; it takes additional time and money and adds anxiety and stress to seemingly simple everyday tasks.

The pediatrician is at the forefront of the mission to ensure proper management. Pediatricians are the first and sometimes the only physician to provide care. The National Institute of Allergy and Infectious Diseases presented Guidelines for the Diagnosis and Management of Food Allergy in 2010, and this was followed by a publication in Pediatrics in 2011 on the applications of food allergy management guidelines in the pediatric population. Guideline-informed care includes proper diagnosis, appropriate testing, prescribing medications, and referral to an allergist. In addition, physicians need to counsel caregivers and children alike on how to recognize a reaction, administer epinephrine, and utilize a food allergy action plan. With new data emerging rapidly, ensuring pediatricians have the tools they need to translate the evidence to the practice level and provide the best care to their patients remains essential.

In this issue, we began by exploring the pathophysiology of food allergy, signs and symptoms, diagnosis, and recommendations for pediatric management at home and at school. We then looked at important questions regarding food allergy around the globe, described quality of life for affected families, differentiated food allergy from food protein-induced enterocolitis syndrome, and explored the association of how both gut microbiome and breast feeding are associated with the development of food allergy. We then wrap up by highlighting new research on the possibility of preventing peanut allergy with early introduction, discuss mechanisms of oral tolerance, and review current work on potential treatments for food allergy.

I am so grateful and indebted to the amazing authors and coauthors for their hard work and willingness to contribute to this issue. Our goal was to develop a comprehensive update on food allergy. Thus, we hope this review will provide the pediatrician with a basic understanding as well as serve as a reference when caring for children with food allergy. I look forward to the next issue on food allergy, where the advancements in knowledge around the possible prevention and treatments may be ready for us to offer to our families.