Rachid Rima, Chatila Talal A
aDivision of Immunology, Boston Children's Hospital bDepartment of Pediatrics, Harvard Medical School, Boston, MA, USA.
Curr Opin Pediatr. 2016 Dec;28(6):748-753. doi: 10.1097/MOP.0000000000000427.
The rise in the prevalence of food allergy over the past decades has focused attention of factors that may impact disease development, most notably the gut microbiota. The gut microbial communities play a crucial role in promoting oral tolerance. Their alteration by such factors as Cesarean section delivery, diet and antibiotics may influence disease development. This review highlights recent progress in our understanding of the role of the gut microbiota in the development of food allergy.
Food allergy is associated with alterations in the gut microbiota or dysbiosis early in life that may be predictive of disease persistence versus tolerance acquisition. Evidence for the benefits of adjunct therapy with probiotics for the prevention of food allergies and for potentiating oral immunotherapy remains circumstantial, with further studies needed to validate its use. Studies in murine models of food allergy suggest that microbial therapy with protolerogenic bacteria such as certain Clostridial species holds promise in future applications for prevention or therapy of food allergy.
Progress in understanding the role of dysbiosis in food allergy and the factors that promote its development, such as antibiotic therapy, diet, modes of infant delivery, and environmental exposures, offer windows of opportunity for both preventive and therapeutic interventions to stem the rising tide of the food allergy epidemic.
在过去几十年中，食物过敏患病率的上升使人们关注可能影响疾病发展的因素，其中肠道微生物群最为显著。肠道微生物群落对促进口服耐受起着至关重要的作用。剖宫产分娩、饮食和抗生素等因素对其造成的改变可能会影响疾病的发展。本综述重点介绍了我们在理解肠道微生物群在食物过敏发展中的作用方面的最新进展。
食物过敏与生命早期肠道微生物群的改变或生态失调有关，这可能预示着疾病的持续存在或耐受的获得。益生菌辅助治疗对预防食物过敏和增强口服免疫疗法有益的证据仍然是间接的，需要进一步研究来验证其用途。食物过敏小鼠模型的研究表明，用某些梭菌属等促耐受性细菌进行微生物治疗在未来预防或治疗食物过敏的应用中具有前景。
在理解生态失调在食物过敏中的作用以及促进其发展的因素（如抗生素治疗、饮食、婴儿分娩方式和环境暴露）方面取得的进展，为预防和治疗干预提供了机会之窗，以遏制食物过敏流行趋势的上升。
