The PATHOGENesis of Food Allergy

Frontiers in Pediatrics

article

Peck Y. Ong¹ 

[1] Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, United States;Department of Pediatrics, Keck School of Medicine, University of Southern California, United States

关键词: archaea;    bacteria;    skin;    atopic dermatitis;    cross-reactivity;    egg allergy;    IgE sensitization;   

DOI  :  10.3389/fped.2019.00484

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The current paper suggests that egg allergy may arise due to microbial proteins that are homologous to egg allergens. These microbial proteins elicit an allergic response and lead to the development of specific microbial IgE molecules. These molecules cross-react with egg allergens and result in egg allergy. Some examples of microbial proteins that share similar sequences as egg allergens are presented in this paper. Food allergy has a negative impact on the quality of life and nutrition. In addition, it can lead to life-threatening reactions. The pathogenesis of food allergy is still not fully understood. Many young children develop food allergy with no known prior ingestion of the food allergen in question. The strong connection between food allergy and atopic dermatitis has been well-documented. While the prevalence of food allergy in the general pediatric population is 4–5%, the prevalence of food allergy in atopic dermatitis is at least 20% (1). This connection between food allergy and atopic dermatitis has led to the suggestion that the skin may be the site of food IgE sensitization, leading to food allergy. The dual-allergen-exposure hypothesis suggests that food allergens are sensitized via eczema, whereas early gastro-intestinal exposure leads to tolerance (2). This hypothesis is supported by multiple basic studies that provide evidence for IgE sensitization via the skin [reviewed in (3)]. In addition, it has been shown that environmental level of peanut allergens is increased in children who developed peanut allergy (4). The early introduction of peanut has led to the prevention of peanut allergy (5). Likewise, early introduction of egg has also met with some success, although the results were not as consistent (3). It has been suggested that improvement in eczema, in addition to early introduction of egg, is needed for successful prevention of egg allergy (6). This suggestion further highlights the importance of skin in the pathogenesis of food allergy. A hypothesis is proposed here that the interaction between the neonatal skin and microbial proteins is important for the development of IgE sensitization and egg allergy.

【 授权许可】

CC BY