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Review
. 2021 Nov 1;37(6):557-564.
doi: 10.1097/MOG.0000000000000780.

Role of the gut-skin axis in IgE-mediated food allergy and atopic diseases

Noor Hidayatul Aini Suaini  1 , Kewin Tien Ho Siah  2   3 , Elizabeth Huiwen Tham  1   4   5   6
Affiliations
Review

Role of the gut-skin axis in IgE-mediated food allergy and atopic diseases

Noor Hidayatul Aini Suaini et al. Curr Opin Gastroenterol. .

Abstract

Purpose of review: In recent years, landmark clinical trials investigating the role of early oral exposure to food antigens for food allergy (FA) prevention have highlighted the importance of immunoregulatory pathways in the 'gut-skin axis'. This review highlights recent literature on the mechanisms of the immune system and microbiome involved in the gut-skin axis, contributing to the development of atopic dermatitis (AD), FA, allergic rhinitis (AR) and asthma. Therapeutic interventions harnessing the gut-skin axis are also discussed.

Recent findings: Epicutaneous sensitization in the presence of AD is capable of inducing Th2 allergic inflammation in the intestinal tract and lower respiratory airways, predisposing one to the development of AR and asthma. Probiotics have demonstrated positive effects in preventing and treating AD, though there is no evident relationship of its beneficial effects on other allergic diseases. Prophylactic skin emollients use has not shown consistent protection against AD, whereas there is some evidence for the role of dietary changes in alleviating AD and airway inflammation. More randomized controlled trials are needed to clarify the potential of epicutaneous immunotherapy as a therapeutic strategy for patients with FA.

Summary: The growing understanding of the gut-skin interactions on allergic disease pathogenesis presents novel avenues for therapeutic interventions which target modulation of the gut and/or skin.

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References

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    1. Łoś-Rycharska E, Gołębiewski M, Sikora M, et al. A combined analysis of gut and skin microbiota in infants with food allergy and atopic dermatitis: A Pilot Study. Nutrients 2021; 13:1682–1701.
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