Microbial regulation of allergic responses to food
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REVIEW
Microbial regulation of allergic responses to food Taylor Feehley & Andrew T. Stefka & Severine Cao & Cathryn R. Nagler
Received: 2 August 2012 / Accepted: 17 August 2012 / Published online: 1 September 2012 # Springer-Verlag 2012
Abstract The incidence of food allergy in developed countries is rising at a rate that cannot be attributed to genetic variation alone. In this review, we discuss the environmental factors that may contribute to the increasing prevalence of potentially fatal anaphylactic responses to food. Decreased exposure to enteric infections due to advances in vaccination and sanitation, along with the adoption of high-fat (Western) diets, antibiotic use, Cesarean birth, and formula feeding of infants, have all been implicated in altering the enteric microbiome away from its ancestral state. This collection of resident commensal microbes performs many important physiological functions and plays a central role in the development of the immune system. We hypothesize that alterations in the microbiome interfere with immune system maturation, resulting in impairment of IgA production, reduced abundance of regulatory T cells, and Th2-skewing of baseline immune responses which drive aberrant responses to innocuous (food) antigens. Keywords Microbiome . Hygiene hypothesis . Dysbiosis . Atopy . Bacteria
This article is published as part of the Special Issue on Food Allergy [34:6]. T. Feehley : A. T. Stefka : S. Cao Committee on Immunology and Department of Pathology, University of Chicago, Chicago, IL, USA C. R. Nagler (*) Department of Pathology, The University of Chicago, Jules F. Knapp Medical Research Building, 924 East 57th Street, R120, Chicago, IL 60637, USA e-mail: [email protected]
Abbreviations TLR Toll-like receptor Treg Regulatory T cells SCFA Short-chain fatty acids LP Lamina propria GF Germ free APC Antigen presenting cell DC Dendritic cell MLN Mesenteric lymph node OVA Chicken egg ovalbumin
Introduction The incidence of food allergy is on the rise. In the US, the Centers for Disease Control and Prevention documented an 18 % increase in the prevalence of reported food allergy in children within a span of just 10 years [1]. As reviewed elsewhere in this volume, genetic variation associated with allergic responses to food accounts for only a small fraction of the overall disease risk and cannot explain a dramatic increase in disease prevalence over such a short time period [2–5]. The focus has, therefore, shifted toward gene-byenvironment interactions. Several hypotheses have been offered for how the environment may be interacting with the immune system to promote allergic disease; of these, the role of the commensal microbiota has recently come to the fore. This chapter will review the epidemiological and experimental evidence suggesting that various environmentally driven alterations in the microbiome are contributing to the increasing prevalence of atopy. We will then examine some of the complex host–microbiome interactions that influence the development of the immune system
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