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The microbial origins of food allergy - 04/03/21

Doi : 10.1016/j.jaci.2020.12.624 
Rima Rachid, MD a, b, , Emmanuel Stephen-Victor, PhD a, b, , Talal A. Chatila, MD, MSc a, b,
a Division of Immunology, Boston Children’s Hospital, Boston, Mass 
b Department of Pediatrics, Harvard Medical School, Boston, Mass 

Corresponding author: Talal A. Chatila, MD, MSc, Division of Immunology, Boston Children’s Hospital, Karp Family Research Bldg, Rm 10-214-B, 1 Blackfan Circle, Boston, MA 02115.Division of ImmunologyBoston Children’s HospitalKarp Family Research BldgRm 10-214-B1 Blackfan CircleBostonMA02115

Abstract

Food allergy (FA) is a significant public health issue, propelled by its rapidly increasing prevalence. Its sharp rise into prominence has focused attention on causative environmental factors and their interplay with the immune system in disease pathogenesis. In that regard, there is now substantial evidence that alterations in the gut microbiome early in life imprint the host gut mucosal immunity and may play a critical role in precipitating FA. These changes may impact key steps in the development of the infant gut microbiome, including its shaping by maternal factors and upon the introduction of solid food (the weaning reaction). These early-life changes may have long-range effects on host immunity that manifest later in time as disease pathology. Experimental studies have shown that resetting the host intestinal immune responses by treatment with either a healthy fecal microbiota transplantation or defined commensal bacterial taxa can prevent or treat FA. The mechanisms by which these interventions suppress FA include restoration of gut immune regulatory checkpoints, notably the retinoic orphan receptor gamma T+ regulatory T cells, the epithelial barrier, and healthy immunoglobulin A responses to the gut commensals. These findings inform human studies currently in progress that evaluate the role of microbial therapies in FA.

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Key words : Food allergy, IgA, IgE, microbiota, microbiome, fecal microbiota transplantation, dysbiosis, regulatory T cells, RORγt+ Treg

Abbreviations used : FMT, FA, GF, ILC, RORγt, Tfh, Treg


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 This work was supported by the National Institutes of Health (grant nos. R01 AI126915 and R21 AI132843 to T.A.C.), the Bunning Food Allergy Fund, and the Jasmine and Paul Mashikian Fund.
 Disclosure of potential conflict of interest: R. Rachid and T. A. Chatila are inventors on published US patent application US10391131B2, which covers methods and compositions for the prevention and treatment of food allergy using microbial treatments; have equity in Pareto Bio; and have pending patent applications related to the use of probiotics in enforcing oral tolerance in food allergy (62/758,161 and 62/823,866). T. A. Chatila is also a cofounder of ParetoBio. E. Stephen-Victor has pending patent applications related to the use of probiotics in enforcing oral tolerance in food allergy (62/758,161 and 62/823,866).


© 2020  American Academy of Allergy, Asthma & Immunology. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 147 - N° 3

P. 808-813 - Marzo 2021 Ritorno al numero
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