From Infancy to Adolescence: The Developmental Trajectory of Food Allergy and Its Relationship with Eosinophilic Esophagitis–Mechanisms, Epidemiology, and Emerging Therapies
Seyferth J, Alexanidou E, Schweizer K, Hörning A, Laffolie Jd (2026)
Publication Type: Journal article, Review article
Publication year: 2026
Journal
Book Volume: 6
Article Number: 22
Journal Issue: 2
Abstract
Food allergy (FA) and eosinophilic esophagitis (EoE) represent two of the most rapidly increasing allergen-driven conditions in pediatric medicine. Both diseases share key immunological features, including Th2 polarization and epithelial barrier dysfunction. Over the past two decades, compelling epidemiological and mechanistic evidence has established EoE as a late-manifesting component of the allergic march—the well-recognized sequential progression of atopic disease in childhood, which typically begins with atopic dermatitis, followed by IgE-mediated food allergy, allergic rhinitis, and asthma. Children with IgE-mediated food allergy carry a substantially elevated risk of developing EoE, and shared genetic susceptibility loci—including CAPN14, TSLP, and filaggrin (FLG)—underscore common pathogenic pathways. We conducted a narrative review of the literature by systematically searching PubMed/MEDLINE, EMBASE, and the Cochrane Library using the terms “eosinophilic esophagitis,” “food allergy,” “atopic march,” “IgE-mediated allergy,” and “pediatric” in combination; articles published from 2000 to March 2026 were considered, with priority given to systematic reviews, meta-analyses, randomized controlled trials, and guideline documents. This narrative review comprehensively examines the epidemiology, pathomechanisms, clinical presentation, diagnostic approach, and therapeutic landscape for pediatric FA and EoE, with particular emphasis on their immunological intersections and the evolving evidence positioning EoE within atopic disease trajectories. We highlight approval of dupilumab for children as young as 1 year with EoE—representing a paradigm shift toward biologic therapy for atopic multimorbidity—and discuss the pipeline of emerging agents including cendakimab, lirentelimab, and anti-IL-5 strategies. Identification of shared pathogenic mechanisms offers promising avenues for unified prevention, early diagnosis, and precision therapeutic approaches for children with multiple atopic diseases.
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Germany (DE)How to cite
APA:
Seyferth, J., Alexanidou, E., Schweizer, K., Hörning, A., & Laffolie, J.d. (2026). From Infancy to Adolescence: The Developmental Trajectory of Food Allergy and Its Relationship with Eosinophilic Esophagitis–Mechanisms, Epidemiology, and Emerging Therapies. Allergies, 6(2). https://doi.org/10.3390/allergies6020022
MLA:
Seyferth, Johanna, et al. "From Infancy to Adolescence: The Developmental Trajectory of Food Allergy and Its Relationship with Eosinophilic Esophagitis–Mechanisms, Epidemiology, and Emerging Therapies." Allergies 6.2 (2026).
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