Institute of Laboratory Medicine, Philipps University Marburg, Baldinger Strasse, 35043 Marburg, Germany.
Murdoch Children's Research Institute and University of Melbourne, Royal Children's Hospital, Melbourne, Australia.
Nat Rev Dis Primers. 2018 Jan 4;4:17098. doi: 10.1038/nrdp.2017.98.
Food allergies manifest in a variety of clinical conditions within the gastrointestinal tract, skin and lungs, with the most dramatic and sometimes fatal manifestation being anaphylactic shock. Major progress has been made in basic, translational and clinical research, leading to a better understanding of the underlying immunological mechanisms that lead to the breakdown of clinical and immunological tolerance against food antigens, which can result in either immunoglobulin E (IgE)-mediated reactions or non-IgE-mediated reactions. Lifestyle factors, dietary habits and maternal-neonatal interactions play a pivotal part in triggering the onset of food allergies, including qualitative and quantitative composition of the microbiota. These factors seem to have the greatest influence early in life, an observation that has led to the generation of hypotheses to explain the food allergy epidemic, including the dual-allergen exposure hypothesis. These hypotheses have fuelled research in preventive strategies that seek to establish desensitization to allergens and/or tolerance to allergens in affected individuals. Allergen-nonspecific therapeutic strategies have also been investigated in a number of clinical trials, which will eventually improve the treatment options for patients with food allergy.
食物过敏在胃肠道、皮肤和肺部的多种临床病症中表现出来，最严重且有时可能致命的表现是过敏性休克。基础、转化和临床研究取得了重大进展，使人们对导致临床和免疫耐受对食物抗原失效从而导致免疫球蛋白 E（IgE）介导反应或非 IgE 介导反应的潜在免疫学机制有了更好的理解。生活方式因素、饮食习惯和母婴相互作用在触发食物过敏的发生中起着关键作用，包括微生物群的定性和定量组成。这些因素在生命早期似乎影响最大，这一观察结果导致了一些假说的产生，以解释食物过敏的流行，包括双重过敏原暴露假说。这些假说推动了预防策略的研究，旨在使受影响的个体对过敏原脱敏和/或产生耐受性。过敏原非特异性治疗策略也在多项临床试验中进行了研究，最终将改善食物过敏患者的治疗选择。
