Mechanism for initiation of food allergy: Dependence on skin barrier mutations and environmental allergen costimulation

Walker, Matthew T.; Green, Jeremy E.; Ferrie, Ryan; Queener, Ashley; Kaplan, Mark H.; Cook‐Mills, Joan M.

doi:10.1016/j.jaci.2018.02.003

Cited by 78 publications

(101 citation statements)

References 95 publications

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“…78 In contrast, Walker et al showed that, in filaggrin (FLG)-deficient mice, epicutaneous sensitization to peanut or OVA required costimulation with Alternaria alternata or house dust mite extract. 97…”

Section: E Xperimental Model S Of Epi Cutaneous S En S Itiz Ati Onmentioning

confidence: 99%

Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented?

Brough

Nadeau

Sindher

et al. 2020

Allergy

178

168

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There is increasing evidence regarding the importance of allergic sensitization through the skin. In this review, we provide an overview of the atopic march and immune mechanism underlying the sensitization and effector phase of food allergy. We present experimental models and human data that support the concept of epicutaneous sensitization and how this forms one half of the dual‐allergen exposure hypothesis. We discuss specific important elements in the skin (FLG and other skin barrier gene mutations, Langerhans cells, type 2 innate lymphoid cells, IL‐33, TSLP) that have important roles in the development of allergic responses as well as the body of evidence on environmental allergen exposure and how this can sensitize an individual. Given the link between skin barrier impairment, atopic dermatitis, food allergy, allergic asthma, and allergic rhinitis, it is logical that restoring the skin barrier and prevention or treating atopic dermatitis would have beneficial effects on prevention of related allergic diseases, particularly food allergy. We present the experimental and human studies that have evaluated this approach and discuss various factors which may influence the success of these approaches, such as the type of emollient chosen for the intervention, the role of managing skin inflammation, and differences between primary and secondary prevention of atopic dermatitis to achieve the desired outcome.

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Section: E Xperimental Model S Of Epi Cutaneous S En S Itiz Ati Onmentioning

confidence: 99%

Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented?

Brough

Nadeau

Sindher

et al. 2020

Allergy

178

168

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“…Luminal food antigens are taken up by intestinal dendritic cells, directly or through the mediation of macrophages, and presented to naïve CD4 + T cells in draining lymph nodes . TGFβ‐ and retinoic acid‐producing dendritic cells favor the production of antigen‐specific, forkhead box protein 3 + (FoxP3 + ) regulatory T cells (T reg ) that play a pivotal role in gut immune tolerance, mainly through the production of IL‐10 and TGFβ …”

Section: Putative Mechanisms Of Actionmentioning

confidence: 99%

“…38 TGFβ-and retinoic acid-producing dendritic cells favor the production of antigen-specific, forkhead box protein 3 + (FoxP3 + ) regulatory T cells (T reg ) that play a pivotal role in gut immune tolerance, mainly through the production of IL-10 and TGFβ. 39 Regarding the mechanisms of FA induction, the exposure to food allergens through a damaged skin barrier may cause allergic sensitization. 39,40 Epithelial disruption in the gastrointestinal tract may interfere with the above-mentioned tolerance pathways and induce the release of damage-driven cytokines, such as IL-25, IL-33, and thymic stromal lymphopoietin (TSLP), thus favoring a skewing to Th2 immune response.…”

Section: Putative Mechanis Ms Of Ac Ti Onmentioning

confidence: 99%

“…39 Regarding the mechanisms of FA induction, the exposure to food allergens through a damaged skin barrier may cause allergic sensitization. 39,40 Epithelial disruption in the gastrointestinal tract may interfere with the above-mentioned tolerance pathways and induce the release of damage-driven cytokines, such as IL-25, IL-33, and thymic stromal lymphopoietin (TSLP), thus favoring a skewing to Th2 immune response. 41 These epithelium-derived cytokines are pivotal in stimulating T helper 2 cells (Th2) and type 2 innate lymphoid cells (ILC2) and dendritic cells.…”

Section: Putative Mechanis Ms Of Ac Ti Onmentioning

confidence: 99%

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Allergen immunotherapy for IgE‐mediated food allergy: There is a measure in everything to a proper proportion of therapy

Pajno

Castagnoli

Muraro³

et al. 2019

Pediatric Allergy Immunology

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IgE‐mediated food allergy (FA) is a potentially life‐threatening condition with a negative impact on quality of life and an increasing prevalence in westernized countries in the recent two decades. A strict avoidance of the triggering food(s) represents the current standard approach. However, an elimination diet may be difficult and frustrating, in particular for common foods, (eg, milk, egg, and peanut). Food allergy immunotherapy (FA‐AIT) may provide an active treatment that enables to increase the amount of food that the patient can intake without reaction during treatment (ie, desensitization), and reduces the risk of potential life‐threatening allergic reaction in the event of accidental ingestion. However, several gaps need still to be filled. A memorable Latin orator stated: “Est modus in rebus” (Horace, Sermones I, 1, 106‐07). This sentence remembers that there is a measure in everything to a proper proportion of therapy. The common sense of measure should find application in each stage of treatment. A personalized approaching should consider the specific willing and features of each patient. Efforts are devoted to improve the efficacy, the safety but also the quality of life of patients suffering from FA. In the near future, it will be important to clarify immunologic pathways of FA‐AIT, and to identify reliable biomarkers in order to recognize the most suitable candidates to FA‐AIT and algorithms for treatments tailored on well‐characterized subpopulations of patients.

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“…6 Moreover, the vast cultural diversity, food avail-ability, tropical and subtropical climates, as well as peanut intake tendencies, all lead to differing dietary and food preparation habits that may not be found in developed economies, all of which cause variability among peanut allergy development. 7,8 In Mexico, the issue regarding peanut allergy among adults has seldom been analyzed; there is a generally held notion that food allergy is more of a problem within the pediatric population. Given these circumstances, the objectives of our study were: Firstly, to determine the prevalence of peanut allergy among a sample group with allergic respiratory diseases, and secondly, to describe the symptoms that are most frequently triggered by peanut ingestion among our sample group of patients.…”

Section: Introductionmentioning

confidence: 99%

Peanut allergy among Mexican adults with allergic respiratory diseases: prevalence and clinical manifestations

Hernández-Colín

Fregoso-Zúñiga

Morales-Romero

et al. 2019

RAM

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Antecedentes: La alergia al cacahuate en adultos con enfermedades respiratorias alérgicas pocas veces ha sido estudiada en México.Objetivo: Establecer la prevalencia de alergia al cacahuate en un grupo de adultos con asma o rinitis alérgica; también se describen los síntomas asociados con la alergia al cacahuate.Métodos: Se realizó estudio transversal en el que analizaron los datos correspondientes a 257 pacientes con enfermedades respiratorias alérgicas, asma o rinitis alérgica, con edad igual o mayor a 16 años; los pacientes fueron reclutados consecutivamente. La alergia al cacahuate se determinó por una prueba cutánea positiva al cacahuate y a través de una entrevista estandarizada. Se estimaron intervalos de confianza (IC) a 95 % para proporciones.Resultados: De los pacientes incluidos, 18 estuvieron sensibilizados al cacahuate (7.0 %, IC 95 % = 4.4-10.9), siete de ellos fueron considerados alérgicos al cacahuate, para una prevalencia de 2.7% (IC 95%: 1.2% - 5.6%). En los pacientes con alergia al cacahuate, los síntomas predominantes fueron los orales, principalmente el prurito en la faringe y en el paladar, seguidos de edema de los labios; entre las molestias respiratorias sobresalieron los estornudos y la rinorrea y, al final, los síntomas cutáneos. No se documentaron reacciones sistémicas al cacahuate.Conclusión: En nuestro estudio, la alergia al cacahuate en adultos con enfermedades respiratorias alérgicas no fue infrecuente.

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Mechanism for initiation of food allergy: Dependence on skin barrier mutations and environmental allergen costimulation

Cited by 78 publications

References 95 publications

Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented?

Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented?

Allergen immunotherapy for IgE‐mediated food allergy: There is a measure in everything to a proper proportion of therapy

Peanut allergy among Mexican adults with allergic respiratory diseases: prevalence and clinical manifestations

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