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Editorial
. 2024 Dec 11:5:1531494.
doi: 10.3389/falgy.2024.1531494. eCollection 2024.

Editorial: New insights in pediatric gastrointestinal food allergies

Laura Carucci  1   2 , Neil Shah  3   4 , Roberto Berni Canani  1   2   5   6
Affiliations
Editorial

Editorial: New insights in pediatric gastrointestinal food allergies

Laura Carucci et al. Front Allergy. .
No abstract available

Keywords: advanced glycation end products; cow milk protein allergy; eosinophilic esophagitis; first 1000 days; gut microbiome; short chain fatty acids; ultraprocessed foods.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Better knowledge on pathogenesis is inspiring effective strategies against food allergy. Food allergy derives from a breakdown of immune tolerance due to a negative interaction between genetics and environmental factors. The development of the immune system is deeply regulated by the gut microbiome. An alteration of the gut barrier leading to the abnormal exposure to food allergens, induces a Th2 inflammatory response and a downregulation of T regulatory cells. Several environmental factors may act as trigger factors inducing gut barrier impairment, like ultraprocessed foods (UPF) consumption, antiseptic agents, and early drugs administration, as well as other factors reducing the biodiversity of the infant gut microbiome, including C—section. Based on this evidence it is important to reduce the exposure to all factors negatively impacting the gut-microbiome immune system axis (red arrow) and to increase the exposure to beneficial factors able to positively influence the axis (green arrows). Once developed, food allergy needs to be managed with a modern multistep approach including Dietary treatment that encompasses (A) Dietary education (allergen avoidance, food substitutes, and healthy diet), (B) Adequate intake of macro and micro-nutrients (stimulation of optimal body growth and development), (C) Active diet therapy (stimulation of immune tolerance); and the oral immunotherapy in combination with biologics in case of food allergy persistence.
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References

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