School of Paediatrics and Child Health Research, University of Western Australia, Princess Margaret Hospital, PO Box D184, Perth, WA 6001, Australia.
Postgrad Med J. 2010 Feb;86(1012):94-9. doi: 10.1136/pgmj.2009.086892.
Immune dysregulation has become a hallmark of the modern era. This has led to an epidemic of disease states that result from failed immune surveillance and inappropriate or maladaptive immune responses to self-antigens (autoimmunity) and environmental antigens (allergy). Although environmental change is clearly implicated, the specific causes are still unconfirmed. Any hope to reverse such immune dysfunction must be based on a clearer understanding of the causal pathways and the environmental factors that may be driving the concerning surge in disease rates. This review explores the role of modern dietary changes that, through their known documented immune effects, may play a role in either promoting or preventing disease. Food allergen avoidance has been largely unsuccessful, and most expert bodies no longer recommend delayed complementary feeding or the avoidance of any specific allergenic foods, unless symptoms develop and allergy is confirmed. Rather, focus has shifted to other factors that may influence the ability to develop immune tolerance. There is now evidence that specific nutrients, such as folate, have the capacity to promote an allergic phenotype by epigenetically altering gene expression during early development. A number of other dietary factors including n-3 polyunsaturated fatty acids, oligosaccharides, probiotics, vitamin D, retinoic acid and other antioxidants may also clearly influence immune function and immune development. This review summarises the current evidence, recommendations and future directions in the context of allergy, with the aim of highlighting the need to further investigate the role of diet and nutrition in disease pathogenesis and prevention.
免疫失调已成为现代的一个标志。这导致了一系列疾病的流行，这些疾病是由于免疫监视失败以及针对自身抗原（自身免疫）和环境抗原（过敏）的不当或适应不良的免疫反应引起的。尽管环境变化显然与此有关，但具体原因仍未得到证实。任何逆转这种免疫功能障碍的希望都必须基于对因果途径的更清楚的了解，以及可能导致疾病发病率令人担忧的上升的环境因素。这篇综述探讨了现代饮食变化的作用，这些变化通过其已知的免疫作用，可能在促进或预防疾病方面发挥作用。避免食物过敏原在很大程度上并未成功，并且大多数专家机构不再建议延迟补充喂养或避免任何特定的过敏原食物，除非出现症状并确认过敏。相反，重点已转移到其他可能影响发展免疫耐受能力的因素上。现在有证据表明，特定的营养素，如叶酸，通过在早期发育过程中通过表观遗传改变基因表达，具有促进过敏表型的能力。许多其他饮食因素，包括 n-3 多不饱和脂肪酸、低聚糖、益生菌、维生素 D、视黄酸和其他抗氧化剂，也可能明显影响免疫功能和免疫发育。这篇综述总结了过敏背景下当前的证据、建议和未来方向，旨在强调需要进一步研究饮食和营养在疾病发病机制和预防中的作用。
