This review highlights some of the research advances in
anaphylaxis;
hypersensitivity reactions to foods, drugs, and insects; and allergic
skin diseases that were reported in the Journal in 2014. Studies on
food allergy suggest worrisomely high rates of
peanut allergy and food-induced
anaphylaxis-related hospitalizations. Evidence is mounting to support the theory that environmental exposure to peanut, such as in
house dust, especially with an impaired skin barrier attributed to
atopic dermatitis (AD) and loss of function mutations in the
filaggrin gene, is a risk factor for sensitization and
allergy. Diagnostic tests are improving, with early studies suggesting the possibility of developing novel cellular tests with increased diagnostic utility. Treatment trials continue to show the promise and limitations of oral
immunotherapy, and mechanistic studies are elucidating pathways that might define the degree of efficacy of this treatment. Studies have also provided insights into the prevalence and characteristics of
anaphylaxis and
insect venom allergy, such as suggesting that baseline
platelet-activating factor acetylhydrolase activity levels are related to the severity of reactions. Advances in
drug allergy include identification of HLA associations for
penicillin allergy and a
microRNA biomarker/mechanism for
toxic epidermal necrolysis. Research identifying critical events leading to skin barrier dysfunction and the polarized immune pathways that drive AD have led to new therapeutic approaches in the prevention and management of AD.