Does Allergy Break Bones? Osteoporosis and Its Connection to Allergy

Abstract

Osteoporosis and allergic diseases are important causes of morbidity, and traditionally their coexistence has been attributed to causality, to independent processes, and they were considered unrelated. However, the increasing knowledge in the field of osteoimmunology and an increasing number of epidemiological and biological studies have provided support to a correlation between bone and allergy that share pathways, cells, cytokines and mediators. If the link between allergic pathology and bone alterations appears more subtle, there are conditions such as mastocytosis and hypereosinophilic or hyper-IgE syndromes characterized by the proliferation of cells or hyper-production of molecules that play a key role in allergies, in which this link is at least clinically more evident, and the diseases are accompanied by frank skeletal involvement, offering multiple speculation cues. The pathophysiological connection of allergy and osteoporosis is currently an intriguing area of research. The aim of this review is to summarize and bring together the current knowledge and pursue an opportunity to stimulate further investigation.

Sex and Gender Aspects for Patient Stratification in Allergy Prevention and Treatment

“…We tried to look through pathogenetic mechanisms, epidemiological, and clinical data to highlight the most up-to-date knowledge. The complexity of allergic inflammation in its several forms [100] supports the need for recognizing sex-gender associated differences to better understand the pathobiology of the allergic diseases. The ultimate goal is to define and understand these differences or their absence and improve prevention, diagnosis, care and treatment of both women and men.…”

New Perspectives in Food Allergy

“…Almost half of patients with IgE-dependent FA have experienced at least one serious anaphylactic reaction, especially in childhood and adolescence [11,19]. The variability of clinical expressions and the complexity of the underlying immunological mechanisms contribute to making diagnosis often difficult and complicate the studies on the epidemiology of FA [20][21][22][23][24][25][26][27][28][29][30].…”

“…Although each type of food may constitute a potential allergen, the list of foods responsible for the great majority of cases, especially the most clinically severe forms, is relatively short [3,10,24]. In industrialized countries the foods most frequently responsible for allergies in children are cow'smilk, eggs, wheat, fish and shellfish, peanuts, walnuts, and soybeans.…”

IL-33/IL-31 Axis in Osteoporosis

“…IL-33-and ST2-knockout mice show homeostatic dysregulation of granulocyte responses in both the blood and bone marrow compartments, suggesting that IL-33 acts on many other cell types besides bone cells, all able to indirectly influence the bone. For example, IL-33 precedes IL-5 in regulating eosinophil commitment [75], contributing to the complex cytokine network driving both allergic and bone diseases [76]. Shulze et al demonstrated that IL-33 directly stopped osteoclast formation from bone marrow precursor cells [70], and Zaiss et al described a shift in the differentiation of myeloid bone marrow progenitors from osteoclasts to macrophages [77].…”