Pathogenesis of food allergy in the pediatric patient

Abstract

In the US and other developed countries, food allergy is a growing epidemic in pediatric populations with a substantial impact on health-related quality of life. As such, there are great efforts underway to unravel the mechanisms of oral mucosal tolerance and to better define the factors related to host and allergen exposure that contribute to the aberrant immune response leading to sensitization and clinical food allergy. Although more research is needed to eventually develop targeted treatment and prevention strategies, this review highlights our current understanding of the pathogenesis of IgE-mediated food allergy.

Figure 1

After taking up antigen in the lamina propria, CD103⁺ dendritic cells (DCs) migrate to the mesenteric lymph node. CD103⁺DCs present antigen to naïve T cells that are induced to differentiate into FoxP3-expressing T-regulatory cells (Tregs) and imprinted with α4β7 and CCR9. After homing back to the gut, CX3CR1⁺ (CD103⁻) cells secrete IL-10 to allow for local expansion of Tregs and induction of oral tolerance. (Adapted from Hadis et al. [•]; copyright 2011, Elsevier; with permission.)