PURPOSE OF REVIEW: The prevalence of food allergy is rising globally. This review will discuss recent discoveries regarding the immunologic mechanisms that drive the initial sensitization and allergic response to food antigens, which may inform prevention and treatment strategies. RECENT FINDINGS: Tolerance to food antigens is antigen-specific and promoted by oral exposure early in life and maternal transfer of immune complexes via breast milk. IgG can inhibit both the initiation and effector phases of allergic responses to food antigens in mice, and high levels of food-specific IgG4 are associated with acquisition of tolerance in humans. Disruption of the skin barrier provides a route for food sensitization through the actions of mast cells, type 2 innate lymphoid cells, and IL-33 signaling. Regulatory T cells (Tregs) promote acquisition of oral tolerance, although defects in circulating allergen-specific Tregs are not evident in children with established food allergy. Certain microbes can offer protection against the development of IgE and food allergic responses, while dysbiosis increases susceptibility to food allergy. SUMMARY: Tolerance to food antigens is antigen-specific and is promoted by oral exposure early in life, maternal transfer of immune complexes, food-specific IgG, Tregs, an intact skin barrier, and a healthy microbiome.
PURPOSE OF REVIEW: The prevalence of food allergy is rising globally. This review will discuss recent discoveries regarding the immunologic mechanisms that drive the initial sensitization and allergic response to food antigens, which may inform prevention and treatment strategies. RECENT FINDINGS: Tolerance to food antigens is antigen-specific and promoted by oral exposure early in life and maternal transfer of immune complexes via breast milk. IgG can inhibit both the initiation and effector phases of allergic responses to food antigens in mice, and high levels of food-specific IgG4 are associated with acquisition of tolerance in humans. Disruption of the skin barrier provides a route for food sensitization through the actions of mast cells, type 2 innate lymphoid cells, and IL-33 signaling. Regulatory T cells (Tregs) promote acquisition of oral tolerance, although defects in circulating allergen-specific Tregs are not evident in children with established food allergy. Certain microbes can offer protection against the development of IgE and food allergic responses, while dysbiosis increases susceptibility to food allergy. SUMMARY: Tolerance to food antigens is antigen-specific and is promoted by oral exposure early in life, maternal transfer of immune complexes, food-specific IgG, Tregs, an intact skin barrier, and a healthy microbiome.
Authors: Jessica H Savage; Kathleen A Lee-Sarwar; Joanne Sordillo; Supinda Bunyavanich; Yanjiao Zhou; George O'Connor; Megan Sandel; Leonard B Bacharier; Robert Zeiger; Erica Sodergren; George M Weinstock; Diane R Gold; Scott T Weiss; Augusto A Litonjua Journal: Allergy Date: 2017-08-02 Impact factor: 13.146
Authors: David Chiang; Xintong Chen; Stacie M Jones; Robert A Wood; Scott H Sicherer; A Wesley Burks; Donald Y M Leung; Charuta Agashe; Alexander Grishin; Peter Dawson; Wendy F Davidson; Leah Newman; Robert Sebra; Miriam Merad; Hugh A Sampson; Bojan Losic; M Cecilia Berin Journal: J Allergy Clin Immunol Date: 2018-01-31 Impact factor: 10.793
Authors: S E Ashley; H-T T Tan; P Vuillermin; S C Dharmage; M L K Tang; J Koplin; L C Gurrin; A Lowe; C Lodge; A-L Ponsonby; J Molloy; P Martin; M C Matheson; R Saffery; K J Allen; J A Ellis; D Martino Journal: Allergy Date: 2017-04-04 Impact factor: 13.146
Authors: Brian P Vickery; Amy M Scurlock; Michael Kulis; Pamela H Steele; Janet Kamilaris; Jelena P Berglund; Caitlin Burk; Anne Hiegel; Suzanna Carlisle; Lynn Christie; Tamara T Perry; Robbie D Pesek; Saira Sheikh; Yamini Virkud; P Brian Smith; Mohamed H Shamji; Stephen R Durham; Stacie M Jones; A Wesley Burks Journal: J Allergy Clin Immunol Date: 2013-12-19 Impact factor: 10.793
Authors: Simone M Hayen; Constance F den Hartog Jager; André C Knulst; Edward F Knol; Johan Garssen; Linette E M Willemsen; Henny G Otten Journal: Front Immunol Date: 2018-06-11 Impact factor: 7.561
Authors: Mauro Calvani; Caterina Anania; Carlo Caffarelli; Alberto Martelli; Michele Miraglia Del Giudice; Claudio Cravidi; Marzia Duse; Sara Manti; Maria Angela Tosca; Fabio Cardinale; Elena Chiappini; Francesca Olivero; Gian Luigi Marseglia Journal: Acta Biomed Date: 2020-09-15