Dietary Immunomodulatory Factors in the Development of Immune Tolerance

West, Christina; D’Vaz, Nina; Prescott, Susan L.

doi:10.1007/s11882-011-0200-0

Cited by 43 publications

(38 citation statements)

References 86 publications

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“…Whether these mechanisms also account for prenatal allergen tolerance mechanisms is not completely clarified. However, emerging evidence suggests that exposures during pregnancy and the early postnatal period can modify gene expression and thus disease propensity (10). Thus, it could be shown that cord blood regulatory T cells are depressed in quantity (total numbers) and quality (function) in atopic as compared to nonatopic mothers (11,12).…”

Section: Tolerance Induction In the Prenatal/perinatal Periodmentioning

confidence: 99%

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Markers of tolerance development to food allergens

Ponce

Diesner

Szépfalusi

et al. 2016

Allergy

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IgE-mediated reactions to food allergens are the most common cause of anaphylaxis in childhood. Although allergies to cow's milk, egg, or soy proteins, in contrast to peanut and tree nut allergens, resolve within the first 6 years of life in up to 60% due to natural tolerance development, this process is not well understood. At present, there is no cure or treatment for food allergy that would result in an induction of tolerance to the symptom-eliciting food. Avoidance, providing an emergency plan and education, is the standard of treatment. Oral immunotherapeutic approaches have been proven reasonable efficacy; however, they are associated with high rates of side-effects and low numbers of patients achieving tolerance. Nevertheless, mechanisms that take place during oral immunotherapy may help to understand tolerance development. On the basis of these therapeutic interventions, events like loss of basophil activation and induction of regulatory lymphocyte subsets and of blocking antibodies have been described. Their functional importance at a clinical level, however, remains to be investigated in detail. Consequently, there is eminent need to understand the process of tolerance development to food allergens and define biomarkers to develop and monitor new treatment strategies for food allergy.IgE-mediated food allergy represents the most important cause of anaphylaxis in childhood. While milk and egg allergy are associated with a high rate of natural tolerance development within the first 6 years of life, this is less clear for other food allergies. Consequently, once it is communicated the diagnosis persists often lifelong severely impacting the quality of life of the patient and the environment despite the recommendation to reconsider clinical tolerance development from time to time.Currently, avoidance, providing an emergency plan and teaching, is the standard of treatment; however, there is no cure or treatment that has reached the level of recommendation to re-induce tolerance to the symptom-eliciting food. Tolerance assessment occurs either via oral food challenges or due to unintended exposure. Given the cost and time intensiveness of oral food challenges and its potential harmfulness, there is eminent need to understand the process of tolerance development and define markers thereof to develop and monitor new treatment strategies for food allergy. This review aimed to provide an overview on recent advances regarding markers and mechanisms of tolerance development to food allergens.Oral tolerance in the context of food allergy is considered to occur if the antigen/food can be ingested without problems despite prolonged periods of avoidance, while the status of desensitization is strictly dependent on regular ingestion of the respective food in order to confer protection from allergic reactions. Currently, there is no general consensus on the exact time frame of avoidance and re-exposure that would allow the usage of the terminus tolerance that is considered equivalent to cure in the context of or...

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Section: Tolerance Induction In the Prenatal/perinatal Periodmentioning

confidence: 99%

“…In this respect, food allergen exposure in the prenatal/perinatal period has been implicated to rather induce tolerance than to trigger disease-causing reactions, such as allergic sensitization (10). Most of recent human studies have focused on peanut as allergen.…”

Section: Tolerance Induction In the Prenatal/perinatal Periodmentioning

confidence: 99%

Markers of tolerance development to food allergens

Ponce

Diesner

Szépfalusi

et al. 2016

Allergy

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“…Further studies should aim at optimizing infant feeding regimens. Supporting the most favorable "tolerogenic" microenvironment in the gut during the period of food allergen introduction is also likely to involve "optimal" colonization of the gastrointestinal tract, breastfeeding, and other dietary factors with immunomodulatory capacity [39,40] .…”

Section: Resultsmentioning

confidence: 99%

“…There are data to suggest that starting complementary foods before 3-4 months of age may increase the risk of allergic disease [37,38] . At that age, the gut is more permeable and gastrointestinal colonization is not yet well established, which might contribute to the observed risk increase [39,40] . Consequently, many international infant feeding guidelines for allergy prevention recommend introduction of any solid food after 4 months of age [32][33][34][35][36] .…”

Section: The "Optimal" Window Of Introduction Of Complementary Foods mentioning

confidence: 99%

Introduction of Complementary Foods to Infants

West

2017

Ann Nutr Metab

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While earlier food allergy prevention strategies implemented avoidance of allergenic foods in infancy, the current paradigm is shifting from avoidance to controlled exposure. This review focuses on the outcome of recent randomized controlled trials, which have examined the early introduction of allergenic foods for allergy prevention, and discusses the implementation of results in clinical practice. In infants at high risk of allergic disease, there is now direct evidence that regular early peanut consumption will reduce the prevalence of peanut allergy, compared to avoidance. Many international infant feeding guidelines already recommend complementary foods, including allergenic foods, to be introduced from 4 to 6 months of age irrespective of family history risk. Interim guidelines from 10 International Pediatric Allergy Associations state that healthcare providers should recommend the introduction of peanut-containing products into the diets of infants at high risk of allergic disease in countries where peanut allergy is prevalent. Direct translation of the results obtained from a cohort of high-risk infants to the general population has proved difficult, and issues regarding feasibility, safety, and cost-effectiveness have been raised. Five randomized placebo-controlled trials have assessed the effects of early egg exposure in infancy with varying results. In a recent comprehensive meta-analysis, there was moderate-certainty evidence that early versus late introduction of egg was associated with a reduced egg allergy risk. Although promising, optimal timing, doses, and if the feeding regimen should be stratified according to infant allergy risk remain to be determined. The single study that assessed introduction of multiple foods from 3 months whilst breastfeeding compared with exclusive breastfeeding until 6 months of age showed no reduction in food allergy prevalence. Future research should aim at optimizing infant feeding regimens and support a tolerogenic gastrointestinal microenvironment during the period of food allergen introduction.

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“…Dietary components may also alter the epigenome to influence immune function, and there is a particular window of vulnerability for this during early development (West et al, 2011). Folate for example is a methyl donor.…”

Section: Perinatal Dietary Influence On Immune System Developmentmentioning

confidence: 99%

Perinatal nutrition programs neuroimmune function long-term: mechanisms and implications

Spencer¹

2013

Front. Neurosci.

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Our early life nutritional environment can influence several aspects of physiology, including our propensity to become obese. There is now evidence to suggest perinatal diet can also independently influence development of our innate immune system. This review will address three not-necessarily-exclusive mechanisms by which perinatal nutrition can program neuroimmune function long-term: by predisposing the individual to obesity, by altering the gut microbiota, and by inducing epigenetic modifications that alter gene transcription throughout life.

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Dietary Immunomodulatory Factors in the Development of Immune Tolerance

Cited by 43 publications

References 86 publications

Markers of tolerance development to food allergens

Markers of tolerance development to food allergens

Introduction of Complementary Foods to Infants

Perinatal nutrition programs neuroimmune function long-term: mechanisms and implications

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