Role of dietary immunomodulatory factors in the development of immune tolerance.

The development of oral tolerance occurs during critical early stages of immune development. Rising rates of food allergy and other immune-mediated food reactions are an indication that oral tolerance is highly susceptible to environmental change. There is growing evidence that this many not be due food allergens per se, but rather to changing exposure to other key immunomodulatory exposures in this critical period. Successful tolerance appears to depend on many concurrent environmental influences during the period of first allergen encounter, including favorable gut colonization, and the presence of key immunomodulatory factors in breast milk and the infant diet. This review explores the potential effects of early dietary and nutritional factors in tolerogenic immune processes that are normally initiated during initial food allergen encounter. Copyright 2009 Nestec Ltd., Vevey/S. Karger AG, Basel.