Oral immunotherapy for food allergy

Freeland, Deborah M. Hussey; Manohar, Monali; Andorf, Sandra; Hobson, Benjamin D.; Zhang, Wenming; Nadeau, Kari

doi:10.1016/j.smim.2017.08.008

Cited by 36 publications

(19 citation statements)

References 94 publications

(95 reference statements)

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“…Indeed, IgG has been shown to inhibit IgE‐mediated mast cell and basophil activation through two mechanisms: antigen interception (competition with IgE epitopes), and cross‐linking of FcεRI with the inhibitory receptor FcγRIIB [107]. Oral immunotherapy (OIT), which is used to desensitize food allergic subjects, increases levels of food‐specific IgG [108, 109]. It has thus been suggested that such IgG (and especially IgG4 that has low affinity for activating FcγRs [110]) can participate in the protective effects conferred by OIT [108, 109].…”

Section: Role Of Ige In Food Allergy and Anaphylaxis: Lessons From Momentioning

confidence: 99%

IgE in the pathophysiology and therapy of food allergy

et al. 2021

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Food allergy is becoming a major public health issue, with no regulatory approved therapy to date. Food allergy symptoms range from skin rash and gastrointestinal symptoms to anaphylaxis, a potentially fatal systemic allergic shock reaction. IgE antibodies are thought to contribute importantly to key features of food allergy and anaphylaxis, and measurement of allergen‐specific IgE is fundamental in diagnosing food allergy. This review will discuss recent advances in the regulation of IgE production and IgE repertoires in food allergy. We will describe the current understanding of the role of IgE and its high‐affinity receptor FcεRI in food allergy and anaphylaxis, by reviewing insights gained from analyses of mouse models. Finally, we will review data derived from clinical studies of the effect of anti‐IgE therapeutic monoclonal antibodies (mAbs) in food allergy, and recent insight on the efficiency and mechanisms through which these mAbs block IgE effector functions.

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Section: Role Of Ige In Food Allergy and Anaphylaxis: Lessons From Momentioning

confidence: 99%

IgE in the pathophysiology and therapy of food allergy

et al. 2021

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“…Several approaches have been developed recently to reduce the occurrence of adverse reactions during milk OIT. Combining OIT and treatment with the monoclonal anti-IgE antibody omalizumab allowed an acceleration of the build-up phase and the reduction of the frequency and severity of side-effects in cow’s milk allergic children, but varying outcomes of efficacy were observed [121,122,123,124,125,126]. However, the high costs of this treatment have to be considered.…”

Section: Current Treatment Strategies For Cow’s Milk Allergymentioning

confidence: 99%

“…Several immunological changes that occur in the course of OIT have been described, as a decrease of allergen-specific IgE and the induction of allergen-specific IgG4 antibodies, a decline in antigen-specific Th2 cells, and the induction of regulatory T cells [126].…”

Section: Current Treatment Strategies For Cow’s Milk Allergymentioning

confidence: 99%

Molecular Approaches for Diagnosis, Therapy and Prevention of Cow’s Milk Allergy

et al. 2019

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Cow´s milk is one of the most important and basic nutrients introduced early in life in our diet but can induce IgE-associated allergy. IgE-associated allergy to cow´s milk can cause severe allergic manifestations in the gut, skin and even in the respiratory tract and may lead to life-threatening anaphylactic shock due to the stability of certain cow´s milk allergens. Here, we provide an overview about the allergen molecules in cow´s milk and the advantages of the molecular diagnosis of IgE sensitization to cow´s milk by serology. In addition, we review current strategies for prevention and treatment of cow´s milk allergy and discuss how they could be improved in the future by innovative molecular approaches that are based on defined recombinant allergens, recombinant hypoallergenic allergen derivatives and synthetic peptides.

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“…Oral immunotherapy (OIT) to treat cow's milk, peanut, and hen's egg allergies has been shown to reduce clinical symptoms upon food challenge but unsuccessfully maintained the protective state upon discontinuation of the therapy [8]. Effective desensitization of effector cells like mast cells and basophils in combination with active modulation of the adaptive immune response via antigen-presenting cells and T and B lymphocytes is key mechanisms in OIT [9]. The use of dietary adjuvants with immunomodulatory properties might open a new window of opportunities to improve the efficacy of OIT for food allergies.…”

Section: Introductionmentioning

confidence: 99%

Butyrate Enhances Desensitization Induced by Oral Immunotherapy in Cow’s Milk Allergic Mice

Vonk

Blokhuis

Diks

et al. 2019

Mediators of Inflammation

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Background In previous studies, we showed that a fructo-oligosaccharide- (FOS-) supplemented diet enhanced oral immunotherapy (OIT) efficacy in a mouse model for cow's milk allergy. Fermentation of FOS by intestinal bacteria leads to production of short-chain fatty acids (SCFA) including butyrate. Aim To investigate the contribution of butyrate in the enhanced efficacy of OIT + FOS. Methods C3H/HeOuJ mice were sensitized and received OIT with or without FOS or butyrate supplementation. After treatment, whole blood was collected to conduct a basophil activation test (BAT) and allergen challenges were performed to measure acute allergic symptoms. CD4 + CD25 + regulatory T cells (Tregs) were isolated from treated mice or differentiated in vitro and used in a bone marrow-derived mast cell (BMMC) suppression assay. Cecum content was collected to analyze SCFA concentrations. Results Allergen-induced basophil activation was reduced in OIT + butyrate samples compared to OIT. Accordingly, the acute allergic skin response and mast cell degranulation upon challenge were reduced in OIT + butyrate and OIT + FOS mice compared to sensitized controls. Butyrate was increased in the cecum content of OIT + FOS mice compared to OIT mice and sensitized controls. Treg-mediated BMMC suppression was enhanced after in vivo butyrate and FOS exposure in combination with OIT but with a more pronounced effect for butyrate. Conclusion Butyrate supplementation enhanced OIT-induced desensitization of basophils and mast cells and Treg functionality. Only OIT + FOS treatment induced potential microbial alterations, shown by increased butyrate levels in cecum content. Both butyrate and FOS are promising candidates to improve OIT efficacy in human studies to treat food allergies.

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Oral immunotherapy for food allergy

Cited by 36 publications

References 94 publications

IgE in the pathophysiology and therapy of food allergy

IgE in the pathophysiology and therapy of food allergy

Molecular Approaches for Diagnosis, Therapy and Prevention of Cow’s Milk Allergy

Butyrate Enhances Desensitization Induced by Oral Immunotherapy in Cow’s Milk Allergic Mice

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