Overview of oral tolerance induction for prevention of food allergy—Where are we now?

Krawiec, Marta; Fisher, Harriet; Toit, George Du; Bahnson, Henry T.; Lack, Gideon

doi:10.1111/all.14758

Cited by 26 publications

(28 citation statements)

References 67 publications

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“…For tolerance induction, there may be a therapeutic window of opportunity between 4 to 6 months of age, typically before multiple allergic sensitizations occur. 97 There is still a paucity of clinical trials on food triggers specific for the Asian population, considering distinct dietary preferences.…”

Section: Interventions For Allergy Preventionmentioning

confidence: 99%

Environmental Influences and Allergic Diseases in the Asia-Pacific Region: What Will Happen in Next 30 Years?

Xing

Wong

2022

Allergy Asthma Immunol Res

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Asia-Pacific is a populous region with remarkable variations in socioeconomic development and environmental exposure among countries. The prevalence rates of asthma and allergic rhinitis appear to have recently reached a plateau in Western countries, whereas they are still increasing in many Asian countries. Given the large population in Asia, even a slight increase in the prevalence rate will translate into an overwhelming number of patients. To reduce the magnitude of the increase in allergic diseases in next few decades in Asia, we must understand the potential factors leading to the occurrence of these disorders and the development of potential preventive strategies. The etiology of allergic disorders is likely due to complex interactions among genetic, epigenetic, and environmental factors for the manifestations of inappropriate immune responses. As urbanization and industrialization inevitably progress in Asia, there is an urgent need to curtail the upcoming waves of the allergy epidemic. Potentially modifiable risk exposure, such as air pollution, should be minimized through timely implementation of effective legislations. Meanwhile, re-introduction of protective factors that were once part of the traditional farming lifestyle might give new insight into primary prevention of allergy.

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Section: Interventions For Allergy Preventionmentioning

confidence: 99%

Environmental Influences and Allergic Diseases in the Asia-Pacific Region: What Will Happen in Next 30 Years?

Xing

Wong

2022

Allergy Asthma Immunol Res

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“…Early complementary feeding (before 3 months of age) has been linked to increased risk of GI and respiratory infections, obesity, and allergies, but this may rather be attributed to shorter duration of breastfeeding [70]. However, late introduction to complementary feeding can also be problematic as it may result in feeding problems, inadequate nutrition and growth [70], and failure to induce oral tolerance [71]. Recent evidence suggests that the infant gut microbiota development may be causally linked to healthy growth [72, 73] and protection against food allergies [74, 75].…”

Section: Complementary Feeding and Gut Microbiotamentioning

confidence: 99%

Gut Microbiota Development: Influence of Diet from Infancy to Toddlerhood

Laursen¹

2021

Ann Nutr Metab

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Early life is a critical period as our gut microbiota establishes here and may impact both current and future health. Thus, it is of importance to understand how different factors govern the complex microbial colonization patterns in this period. The gut microbiota changes substantially during infancy and toddlerhood in terms of both taxonomic composition and diversity. This developmental trajectory differs by a variety of factors, including term of birth, mode of birth, intake of antibiotics, presence of furred pets, siblings and family members, host genetics, local environment, geographical location, and maternal and infant/toddler diet. The type of milk feeding and complementary feeding is particularly important in early and late infancy/toddlerhood, respectively. Breastfeeding, due to the supply of human milk oligosaccharide into the gut, promotes the growth of specific human milk oligosaccharide (HMO)-utilizing <i>Bifidobacterium</i> species that dominate the ecosystem as long as the infant is primarily breastfed. These species perform saccharolytic fermentation in the gut and produce metabolites with physiological effects that may contribute to protection against infectious and immune-related diseases. Formula feeding, due to its lack of HMOs and higher protein content, give rise to a more diverse gut microbiota that contains more opportunistic pathogens and results in a more proteolytic metabolism in the gut. Complementary feeding, due to the introduction of dietary fibers and new protein sources, induces a shift in the gut microbiota and metabolism away from the milk-adapted and toward a more mature and diverse adult-like community with increased abundances of short chain fatty acid-producing bacterial taxa. While the physiological implication of these complementary diet-induced changes remains to be established, a few recent studies indicate that an inadequately matured gut microbiota may be causally related to poor growth and development. Further studies are required to expand our knowledge on interactions between diet, gut microbiota, and health in the early life setting.

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“…108 In a prospective study, exposure to wheat before the age of 6 months reduced occurrence of allergy as compared with children who were given wheat first 7 months of 109 Early childhood oral tolerance induction is feasible in children who have not yet developed true food allergy for peanut or egg. 110 Oral immunotherapy is also a promising therapy for food allergy in older children up to adolescence. Efficacy has been shown in milk, peanut, egg, and wheat allergy.…”

Section: Case Food Allergymentioning

confidence: 99%

Immunological resilience and biodiversity for prevention of allergic diseases and asthma

Haahtela

Alenius

Lehtimäki

et al. 2021

Allergy

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Increase of allergic conditions has occurred at the same pace with the Great Acceleration, which stands for the rapid growth rate of human activities upon earth from 1950s. Changes of environment and lifestyle along with escalating urbanization are acknowledged as the main underlying causes. Secondary (tertiary) prevention for better disease control has advanced considerably with innovations for oral immunotherapy and effective treatment of inflammation with corticosteroids, calcineurin inhibitors, and biological medications. Patients are less disabled than before. However, primary prevention has remained a dilemma. Factors predicting allergy and asthma risk have proven complex: Risk factors increase the risk, while protective factors counteract them. Interaction of human body with environmental biodiversity with micro-organisms and biogenic compounds as well as the central role of epigenetic adaptation in immune homeostasis have given new insight. Allergic diseases are good indicators of the twisted relation to environment. In various non-communicable diseases, the protective mode of the immune system indicates low-grade inflammation without apparent cause. Giving microbes, pro-and prebiotics, has shown some promise in prevention and treatment. The real-world public health programme in Finland (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018) emphasized nature relatedness and protective factors for immunological resilience, instead of avoidance. The nationwide action mitigated the allergy burden, but in the lack of controls, primary preventive effect remains to be proven. The first results of controlled biodiversity interventions are promising. In the fast urbanizing world, new approaches are called for allergy prevention, which also has a major cost saving potential.

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Overview of oral tolerance induction for prevention of food allergy—Where are we now?

Cited by 26 publications

References 67 publications

Environmental Influences and Allergic Diseases in the Asia-Pacific Region: What Will Happen in Next 30 Years?

Environmental Influences and Allergic Diseases in the Asia-Pacific Region: What Will Happen in Next 30 Years?

Gut Microbiota Development: Influence of Diet from Infancy to Toddlerhood

Immunological resilience and biodiversity for prevention of allergic diseases and asthma

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