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Review
. 2020 Feb 21;21(4):1474.
doi: 10.3390/ijms21041474.

New Perspectives in Food Allergy

Massimo De Martinis  1   2 , Maria Maddalena Sirufo  1   2 , Mariano Suppa  3 , Lia Ginaldi  1   2
Affiliations
Review

New Perspectives in Food Allergy

Massimo De Martinis et al. Int J Mol Sci. .

Abstract

The improvement of the knowledge of the pathophysiological mechanisms underlying the tolerance and sensitization to food antigens has recently led to a radical change in the clinical approach to food allergies. Epidemiological studies show a global increase in the prevalence of food allergy all over the world and manifestations of food allergy appear increasingly frequent also in elderly subjects. Environmental and nutritional changes have partly changed the epidemiology of allergic reactions to foods and new food allergic syndromes have emerged in recent years. The deepening of the study of the intestinal microbiota has highlighted important mechanisms of immunological adaptation of the mucosal immune system to food antigens, leading to a revolution in the concept of immunological tolerance. As a consequence, new prevention models and innovative therapeutic strategies aimed at a personalized approach to the patient affected by food allergy are emerging. This review focuses on these new perspectives and their practical implications in the management of food allergy, providing an updated view of this complex pathology.

Keywords: allergic sensitization; food allergy; food allergy treatment; gut microbiota; immune tolerance; mucosal immunity; translational immunology.

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Conflict of interest statement

The authors declare no conflict of interest

Figures

Figure 1
Figure 1
Main mechanisms by which the breakdown of tolerance to food antigens can occur. A disrupted skin barrier can provide a pathway for the breakdown of tolerance and, through the pro-inflammatory action of epithelial cells, mastcells, and innate type 2 lymphoid cells (ILC2), in addition to cytokines, such as IL-33, promotes the sensitization to food allergens. Cytokines from damaged epitheliocytes and Th2-oriented dendritic cells shift lymphocyte differentiation towards a Th2 phenotype and inhibit T regulatory cells (Treg). Th2 cytokines drive the isotypic switching of B lymphocytes, leading to the production of allergen-specific IgE that anchor to the surface of mastcells and basophils and also induce eosinophil differentiation and homing.
See this image and copyright information in PMC

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