Advances in conventional and innovative anti-allergic agents for managing food allergies: from mechanisms to challenges

Food allergies constitute a significant and escalating global public health issue. Over the past decade, efforts have intensified to prevent and treat these allergies, including exploring new anti-allergic agents and natural bioactive compounds with minimal side effects. Despite progress, consensus on effective strategies remains elusive. This study undertakes a comprehensive review and discussion of current anti-allergic medications, natural bioactive ingredients, and innovative nano/micro-carriers, focusing on four key mechanisms: binding to allergen epitopes, modulating gut microbiota, restoring intestinal epithelial integrity, and regulating immune responses. Many natural compounds show effectiveness through multiple pathways. Advances in nanotechnology have improved delivery systems such as nanoparticles and sporopollenin exine capsules, enhancing targeted delivery and efficacy. Given the distinct cellular and molecular targets of these anti-allergic agents, investigating synergies between natural and synthetic drugs is essential. For instance, combine traditional anti-allergic drugs with glucocorticoids to quickly relieve initial symptoms; then, use natural agents like probiotics for immune regulation, reducing treatment time and recurrence risk. This review lays the foundation for a scientific framework to guide the future development of combination therapy models in clinical applications.