The Microbiome, Timing, and Barrier Function in the Context of Allergic Disease

Wesemann, Duane R.; Nagler, Cathryn R.

doi:10.1016/j.immuni.2016.02.002

Cited by 135 publications

(125 citation statements)

References 139 publications

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“…The prevalence of allergic disease has increased over the past 50 years, with an estimated 10% of preschool children suffering from food allergies. 22–23 It has been hypothesized that Th2 immunity developed to provide protection against worms and parasites; however, the majority of allergens are not helminths or their products. 14,24 The toxin hypothesis of allergy offers a different perspective, and postulates that allergic responses involve excessive immune reactivity in some individuals, as a cost of protection against noxious damage.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population

Bourne

Waltz

Casper

et al. 2017

Journal of the Neurological Sciences

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Background Multiple sclerosis (MS) and allergies are both considered to be related to imbalanced Th1 and Th2 immune responses. Previous studies evaluating the relationship between MS and allergies provide conflicting results. Objective To assess allergies and asthma as risk factors for MS and as predictors of MS relapses in a pediatric cohort. Methods The environment and genetic risk factors for pediatric MS study is a national case-control project with 16 participating US sites. An environmental questionnaire is used that includes history of allergies in the first five years of life. Case-control data are entered in the pediatric MS Network database and cases at 12 of the 16 sites enter relapse data prospectively. Annualized relapse rate was calculated for patients with follow-up and adjusted for age at disease onset, gender, race, ethnicity, and use of disease-modifying therapy (DMT). Results We included 271 cases (mean age at disease onset of 15.7 years and 62% female) and 418 controls. Relapse data were available for 193 cases. There was no difference in prevalence of allergies or asthma between cases and controls. Patients with food allergies had fewer relapses compared to patients without food allergies (.14 vs .48, p = .01). Conclusions While allergies and asthma are not associated with pediatric MS, cases with food allergies have fewer relapses compared to those without food allergies.

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Section: Discussionmentioning

confidence: 99%

Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population

Bourne

Waltz

Casper

et al. 2017

Journal of the Neurological Sciences

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“…Increasing knowledge of how the immune response is influenced by the microbiota is revealing new approaches to treat diseases such as food allergy. While there is already promising evidence in support of manipulating the microbiota during early life to prevent allergic sensitization, it is not yet clear if a stably established gut microbiota can be effectively manipulated to treat food allergy (109). We do know that, in adults, the microbiota can be readily altered, on even daily timescales, by changes in components of the diet, particularly fiber (4, 15, 110).…”

Section: Discussionmentioning

confidence: 99%

The Influence of the Microbiome on Allergic Sensitization to Food

Plunkett

Nagler

2017

The Journal of Immunology

101

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The alarming increase in both the incidence and severity of food allergies has coincided with lifestyle changes in Western societies, such as dietary modifications and increased antibiotic use. These demographic shifts have profoundly altered the co-evolved relationship between host and microbiota, depleting bacterial populations critical for the maintenance of mucosal homeostasis. There is increasing evidence that the dysbiosis associated with sensitization to food fails to stimulate protective tolerogenic pathways, leading to the development of the Type 2 immune responses that characterize allergic disease. Defining the role of beneficial, allergy protective members of the microbiota in the regulation of tolerance to food has exciting potential for new interventions to treat dietary allergies by modulation of the microbiota.

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“…Evidence also suggests that the microbiome of children with and without food allergy 130 and food sensitization 130 differs in terms of alpha and beta-diversity and specific organism strains present. Recent review papers 128,132,133 eloquently summarize that the human gut and its microbiome, the immune system, and dietary intake all influence and depend on each other. 131 The gut microbiome plays an important role in ensuring not only a physical but also an immunological gut barrier, which is of particular relevance in food allergy.…”

Section: Posed By the Future Of Nutrition Sciencementioning

confidence: 99%

“…128 There is some evidence that a more diverse diet may prevent allergic diseases, 134,135 but its definition and usefulness in the management of food allergy are still unclear. 128 There is some evidence that a more diverse diet may prevent allergic diseases, 134,135 but its definition and usefulness in the management of food allergy are still unclear.…”

Section: Posed By the Future Of Nutrition Sciencementioning

confidence: 99%

A patient‐specific approach to develop an exclusion diet to manage food allergy in infants and children

Venter

Groetch

Netting

et al. 2018

Clin Experimental Allergy

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Food allergy is becoming increasingly common in infants and young children. This article set out to explain the different factors that should be taken into account during an individualized allergy consultation: Foods to avoid and degree of avoidance, suitable alternatives, self-management skills, co- and cross-reactive allergens and novel allergens alongside the role of the industry in allergen avoidance, importance of nutritional aspects of the diet and the future directions that nutritional guidance make take. Allergy management advice should be individualized to provide a patient-specific approach. Changes in the management of food allergies have in particular occurred in nut, milk and egg allergies over the past few years. There has also been a progressive increase in our understanding of cross-reactivity between different foods and also food and aero-allergens. A patient-specific approach of allergen avoidance should consider factors relating to industry and the environment such as food and nutrition literacy, threshold levels, cross-contact/contamination and safe eating away from home. Increasing migration and travel has also led to exposure of unfamiliar foods. As understanding improves on individual allergens and threshold levels, food labels and food labelling laws are affected. Allergy specialist dietitians should also keep up to date with the latest information on nutrition, the gut microbiome and the immune system to incorporate nutrition strategies in a dietetic consultation using an evidence-based approach.

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The Microbiome, Timing, and Barrier Function in the Context of Allergic Disease

Cited by 135 publications

References 139 publications

Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population

Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population

The Influence of the Microbiome on Allergic Sensitization to Food

A patient‐specific approach to develop an exclusion diet to manage food allergy in infants and children

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