Interplay between barrier epithelial cells and dendritic cells in allergic sensitization through the lung and the skin

Deckers, Julie; Bosscher, Karolien De; Lambrecht, Bart N.; Hammad, Hamida

doi:10.1111/imr.12542

Cited by 66 publications

(75 citation statements)

References 158 publications

(368 reference statements)

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“…Several excellent reviews have been written on the topics of lung epithelial cell development and maintenance [9], pulmonary barrier immunity to bacterial and viral pathogens [10, 11], and epithelium-dependent allergic responses to model allergens, such as ovalbumin and house dust mite extracts [12]. This review will discuss recent advances in our understanding of how epithelial cells recognize and respond to the threat of fungal invasion and promote antifungal immunity.…”

Section: Introductionmentioning

confidence: 99%

Lung epithelium: barrier immunity to inhaled fungi and driver of fungal-associated allergic asthma

Wiesner

Klein

2017

Current Opinion in Microbiology

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Fungi are ubiquitous in the environment. The epithelium that lines our airways is the first point of contact with the frequent encounter of inhaled fungi. Consequently, the lung epithelium has evolved behaviors that instruct the earliest immune events to resist fungal penetration. Although the epithelium efficiently assists in immunity to invasive fungi, it also can be inappropriately triggered, to the detriment of the host, by normally innocuous fungi or fungal components. Thus, there is a tipping point of protective immunity against fungal pathogens versus inflammatory disease caused by an exuberant immune response to harmless fungal antigens. This review will discuss several aspects of barrier immunity to pulmonary fungal infection, as well as situations where fungal exposure leads to allergic asthma.

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Section: Introductionmentioning

confidence: 99%

Lung epithelium: barrier immunity to inhaled fungi and driver of fungal-associated allergic asthma

Wiesner

Klein

2017

Current Opinion in Microbiology

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“…The T cell circuitry in asthma is best understood for CD4 + T cells and is discussed in this context. Exposure to environmental triggers at the epithelial barrier is pivotal to T cell priming, differentiation and activation . The classical view is that allergens favour the induction of Th2 cells, whereas microbes, including respiratory bacteria and viruses, induce a Th1 response.…”

Section: T Cells and Severe Asthma: Current Conceptsmentioning

confidence: 99%

T cells in severe childhood asthma

Paul

Muehling

Eccles

et al. 2019

Clin Experimental Allergy

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Summary Severe asthma in children is a debilitating condition that accounts for a disproportionately large health and economic burden of asthma. Reasons for the lack of a response to standard anti‐inflammatory therapies remain enigmatic. Work in the last decade has shed new light on the heterogeneous nature of asthma, and the varied immunopathologies of severe disease, which are leading to new treatment approaches for the individual patient. However, most studies to date that explored the immune landscape of the inflamed lower airways have focused on adults. T cells are pivotal to the inception and persistence of inflammatory processes in the diseased lungs, despite a contemporary shift in focus to immune events at the epithelial barrier. This article outlines current knowledge on the types of T cells and related cell types that are implicated in severe asthma. The potential for environmental exposures and other inflammatory cues to condition the immune environment of the lung in early life to favour pathogenic T cells and steroid resistance is discussed. The contributions of T cells and their cytokines to inflammatory processes and treatment resistance are also considered, with an emphasis on new observations in children that argue against conventional type 1 and type 2 T cell paradigms. Finally, the ability for new technologies to revolutionize our understanding of T cells in severe childhood asthma, and to guide future treatment strategies that could mitigate this disease, is highlighted.

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“…While allergen contact via eczematous skin may cause allergic sensitization, the exposure via the gastrointestinal tract is more likely to induce immunological tolerance [11,82,83]. Prolonged avoidance of a food allergen in infants with eczema may paradoxically increase the risk of food allergies [12,84].…”

Section: Dual Allergen Exposure Hypothesismentioning

confidence: 99%

Food Allergy Prevention and Treatment by Targeted Nutrition

Heine¹

2018

Ann Nutr Metab

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In view of the dramatic rise in the prevalence of food allergy globally, effective prevention strategies have become a public health priority. Several models have emerged around the etiology of food allergy, including the hygiene hypothesis, dual allergen exposure hypothesis, and vitamin D hypothesis. These form the basis for current and potential prevention strategies. Breastfeeding remains a key pillar of primary allergy prevention. Other nutritional interventions, including the use of whey-based, partially hydrolyzed formula in non-breastfed infants, also play an important role. In recent years, there has been a shift away from prolonged food allergen avoidance to the proactive allergen introduction from 4 months of age. This approach is supported by 2 pivotal randomized clinical trials showing that the early introduction of peanut and other food allergens significantly reduces the risk of food allergy. However, the implementation of this strategy at the population level still raises significant logistic problems, including patient selection and development of suitable food formats for young infants. Other prevention strategies, including vitamin D supplementation, are currently under evaluation. Maternal elimination diets during pregnancy and lactation are not recommended for allergy prevention. The treatment of food allergies has also seen major transformations. While strict allergen avoidance is still the key treatment principle, there is a greater focus on desensitization and tolerance induction by oral and epicutaneous immunotherapy. In addition, specialized hypoallergenic infant formulas for the treatment of infants with cow’s milk allergy have undergone reformulation, including the addition of lactose and probiotics in order to modulate the gut microbiome and early immune responses. Further research is needed to inform the most effective food allergy prevention strategies at the population level. In addition, the wider application of food allergen immunotherapy may provide better health outcomes and improved quality of life for families affected by food allergies.

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Interplay between barrier epithelial cells and dendritic cells in allergic sensitization through the lung and the skin

Cited by 66 publications

References 158 publications

Lung epithelium: barrier immunity to inhaled fungi and driver of fungal-associated allergic asthma

Lung epithelium: barrier immunity to inhaled fungi and driver of fungal-associated allergic asthma

T cells in severe childhood asthma

Food Allergy Prevention and Treatment by Targeted Nutrition

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