Oral tolerance induction and food allergy prevention

2019 ◽  
Vol 88 (3) ◽  
pp. 177-183
Author(s):  
Natallia Tsikhan ◽  
Mikhail Belevtsev

This review aims to provide an overview of the issue of oral tolerance induction in early childhood and allergy manifestation. We discuss changes in epidemiology of allergic diseases that have occurred over the last decades in the context of current knowledge about environmental factors affecting prevalence of these diseases. Also this article presents current data about causes of "hygiene hypothesis" expansion to "microflora hypothesis" as well as an immunological background of this process; describes how immune factors of cord blood and breast milk, maternal and infant’s elimination diet, timing a solid food intake impact on immune system development and tolerance induction in early childhood. Current knowledge on issues of tolerance induction and allergy should induce update of allergy prevention recommendations in the nearest future.

Author(s):  
Natália Pinheiro-Rosa ◽  
Lícia Torres ◽  
Mariana de Almeida Oliveira ◽  
Marcos Felipe Andrade de Oliveira ◽  
Mauro Andrade de Freitas Guimaraes ◽  
...  

Abstract Oral tolerance is a physiological phenomenon described more than a century ago as a suppressive immune response to antigens that gain access to the body by the oral route. It is a robust and long-lasting event with local and systemic effects in which the generation of mucosally-induced regulatory T cells (iTreg) play an essential role. The idea of using oral tolerance to inhibit autoimmune and allergic diseases by oral administration of target antigens was an important development that was successfully tested in 1980’s. Since then, several studies have shown that feeding specific antigens can be used to prevent and control chronic inflammatory diseases in both animal models and clinically. Therefore, oral tolerance can be classified as an antigen-specific form of oral immunotherapy (OIT). In the light of novel findings on mechanisms, sites of induction and factors affecting oral tolerance, this review will focus on specific characteristics of oral tolerance induction and how they impact in its therapeutic application.


2020 ◽  
Vol 36 (1) ◽  
pp. 511-528
Author(s):  
Kirsty Logan ◽  
George Du Toit ◽  
Mattia Giovannini ◽  
Victor Turcanu ◽  
Gideon Lack

Pediatric allergic disease is a significant health concern worldwide, and the prevalence of childhood eczema, asthma, allergic rhinitis, and food allergy continues to increase. Evidence to support specific interventions for the prevention of eczema, asthma, and allergic rhinitis is limited, and no consensus on prevention strategies has been reached. Randomized controlled trials investigating the prevention of food allergy via oral tolerance induction and the early introduction of allergenic foods have been successful in reducing peanut and egg allergy prevalence. Infant weaning guidelines in the United Sates were recently amended to actively encourage the introduction of peanut for prevention of peanut allergy.


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