A role for early oral exposure to house dust mite allergens through breast milk in IgE-mediated food allergy susceptibility

Abstract

(CAPES)-Comit e français d'Evaluation de la Coop eration universitaire et scientifique avec le Br esil (COFECUB) program (no. 867/15), the Larsson-Rosenquist Foundation, and the University of Western Australia. Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.

House dust mites: Does a clean mattress mean Der p 1‐free breastmilk?

“…1,5,6 This observation may be explained by evidence showing that most of the inhaled large particles and proteins, including Der p 1, are ingested. 3,7 While early oral exposure to an allergen may be expected to lead to protection, as shown for food allergy by early introduction of peanut in the diet, 8 allergy risk was increased upon oral exposure to Der p1 through breastmilk in mouse models 2,6 and birth cohorts. 1,2 There was a positive association between the levels of Der p 1 in maternal milk and the risk of allergic sensitization and respiratory allergy in children.…”

“…3,7 While early oral exposure to an allergen may be expected to lead to protection, as shown for food allergy by early introduction of peanut in the diet, 8 allergy risk was increased upon oral exposure to Der p1 through breastmilk in mouse models 2,6 and birth cohorts. 1,2 There was a positive association between the levels of Der p 1 in maternal milk and the risk of allergic sensitization and respiratory allergy in children. 1 Some preliminary evidence in birth cohorts also suggests a role for Der p in breastmilk in food allergy risk.…”

“…1 Some preliminary evidence in birth cohorts also suggests a role for Der p in breastmilk in food allergy risk. 2 In a mouse model, exposure to Der p 1 through breastmilk disrupted the neonatal gut barrier and triggered critical immunologic events for the development of both respiratory and food allergy. 2,6 The priming effect of oral exposure to Der p was found to rely on the strong intrinsic adjuvant property of Der p allergens, that is their protease activity, which is absent from peanut's allergens.…”

The role of IgE, IgG, and IgA in tolerance, sensitization, and targeted treatment of allergic disease

“…A study in mice showed that mice nursed by HDM-exposed mothers exposed developed a gut immunity imbalance associated with the expansion of Th2 cells and a refractory state to oral tolerance. Importantly, when neutralising HDM protease activity, this deleterious effect on gut immune ontogeny in offspring was abolished 89 . This observation highlights the importance of the biological properties of the allergen itself, as in the case of HDM, the proteolytic activity of the allergens was responsible for immune priming 89 .…”

Dietary Interventions and Nutritional Factors in the Prevention of Pediatric Asthma

“…Increasing evidence shows that breast milk plays a central role in the development of tolerogenic immune responses during the first years of life, due to its content in immunoglobulins, vitamin A and transforming growth-factors, which promote the gut mucosal barrier integrity and homeostasis ( 35 , 36 ). Significantly, it has been observed that certain aeroallergens such as dust mite allergens, when found in breast milk, can increase the risk for developing food allergy, as they could disrupt intestinal immune homeostasis through their protease activity and prevent the induction of oral tolerance to food allergens ( 37 ). Regarding asthma, breast milk appears to have a protective, dose-dependent impact on respiratory health, especially for preschool wheezing, although the mechanisms of how breastfeeding reduces the risk of childhood wheezing/asthma is not fully elucidated ( 38 ).…”