Antiallergic Strategies: Induction of Tolerance to Food

TY - CHAP

T1 - Antiallergic Strategies

T2 - Induction of Tolerance to Food

AU - Lack, Gideon

AU - Santos, Alexandra

AU - Penagos, Martin

AU - Allen, Katrina

N1 - Publisher Copyright: © 2016 Elsevier Inc.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Oral tolerance can be defined from an immunological and clinical point of view. Immunologically, oral tolerance is an antigen-specific suppression of cellular and humoral responses to dietary and bacterial antigens after exposure in the gastrointestinal tract. Clinically, oral tolerance is the ability to eat food without developing immunologically mediated symptoms irrespective of the frequency and quantity of food consumed. There are different phenotypes of oral tolerance to foods. Most food-tolerant individuals do not develop immunoglobulin E sensitization to foods; however, some do and a subset of these develop clinical food allergy. Different phenotypes may have different underlying immunological mechanisms, which we explore. With the increasing prevalence of food allergy, various environmental factors have been investigated as possible risk or protective factors for the development of food allergy, including the balance and timing of routes of exposure to food (e.g., cutaneous and gastrointestinal) in early life. For example, randomized controlled trials are currently under way to assess whether early introduction of allergenic foods such as peanuts and eggs can prevent the development of food allergy. Allergen-specific immunotherapy has been trialed in the management of food-allergic patients: namely, sublingual and oral immunotherapy with single or multiple foods, with and without adjuvant therapies such as probiotics and omalizumab, in an attempt to increase safety and efficacy.

AB - Oral tolerance can be defined from an immunological and clinical point of view. Immunologically, oral tolerance is an antigen-specific suppression of cellular and humoral responses to dietary and bacterial antigens after exposure in the gastrointestinal tract. Clinically, oral tolerance is the ability to eat food without developing immunologically mediated symptoms irrespective of the frequency and quantity of food consumed. There are different phenotypes of oral tolerance to foods. Most food-tolerant individuals do not develop immunoglobulin E sensitization to foods; however, some do and a subset of these develop clinical food allergy. Different phenotypes may have different underlying immunological mechanisms, which we explore. With the increasing prevalence of food allergy, various environmental factors have been investigated as possible risk or protective factors for the development of food allergy, including the balance and timing of routes of exposure to food (e.g., cutaneous and gastrointestinal) in early life. For example, randomized controlled trials are currently under way to assess whether early introduction of allergenic foods such as peanuts and eggs can prevent the development of food allergy. Allergen-specific immunotherapy has been trialed in the management of food-allergic patients: namely, sublingual and oral immunotherapy with single or multiple foods, with and without adjuvant therapies such as probiotics and omalizumab, in an attempt to increase safety and efficacy.

KW - Food allergy

KW - IgE

KW - Immunotherapy

KW - Oral tolerance

KW - Prevention

KW - Sensitization

UR - http://www.scopus.com/inward/record.url?scp=85129422809&partnerID=8YFLogxK

U2 - 10.1016/B978-0-12-420226-9.00021-8

DO - 10.1016/B978-0-12-420226-9.00021-8

M3 - Chapter

AN - SCOPUS:85129422809

SN - 9780127999302

SP - 351

EP - 376

BT - Allergy, Immunity and Tolerance in Early Childhood

PB - Elsevier

ER -