Microbiome Therapeutics for Food Allergy

Abstract

The prevalence of food allergies continues to rise, and with limited existing therapeutic options there is a growing need for new and innovative treatments. Food allergies are, in a large part, related to environmental influences on immune tolerance in early life, and represent a significant therapeutic challenge. An expanding body of evidence on molecular mechanisms in murine models and microbiome associations in humans have highlighted the critical role of gut dysbiosis in the pathogenesis of food allergies. As such, the gut microbiome is a rational target for novel strategies aimed at preventing and treating food allergies, and new methods of modifying the gastrointestinal microbiome to combat immune dysregulation represent promising avenues for translation to future clinical practice. In this review, we discuss the intersection between the gut microbiome and the development of food allergies, with particular focus on microbiome therapeutic strategies. These emerging microbiome approaches to food allergies are subject to continued investigation and include dietary interventions, pre- and probiotics, microbiota metabolism-based interventions, and targeted live biotherapeutics. This exciting frontier may reveal disease-modifying food allergy treatments, and deserves careful study through ongoing clinical trials.

Leuconostoc mesenteroides WHH1141 ameliorates ovalbumin‐induced food allergy in mice

“…If proven effective in large‐scale clinical trials, L. mesenteroides WHH1141 may enable individuals with FA symptoms to reduce the risk of allergic reactions. However, several challenges and considerations need to be addressed for clinical trials (Chernikova et al., 2022). First, a large number of tests are required to confirm the safety and efficacy of WHH1141 interventions without any adverse effects.…”

Synthetic biology in multicellular organisms: Opportunities in nematodes

“…The use of organisms for therapeutic purposes is not limited to preclinical testing, but includes direct applications as therapeutic agents in what is known as live biotherapeutics. Such approaches can use engineered or non‐engineered organisms, mainly bacteria, which are typically delivered to the gut, or topically, or via injection (Charbonneau et al, 2020; Chernikova et al, 2022; FDA, 2016; Huang et al, 2022). Currently, such organisms are in clinical trials to treat solid tumors, gastrointestinal inflammation, or metabolic disorders (hyperammonemia or phenylketonuria) among others (Charbonneau et al, 2020).…”

The clinical and immunological basis of early food introduction in food allergy prevention

“…It plays an important role in the absorption of electrolytes by the intestine, in the mucosal integrity and in local and systemic metabolic function ( 35 , 36 ). Therefore, butyrate has a significant effect on the gut microbiome leading to the stimulation of regulatory immune responses and the gut microbiome itself also has an important effect on allergy development, as reviewed by Chernikova and colleagues ( 43 ).…”