Division of Rheumatology/Allergy and Clinical Immunology, School of Medicine, The University of California, 451 Health Sciences Drive, Suite 6510, Davis, California, 95616, USA.
School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Clin Rev Allergy Immunol. 2019 Aug;57(1):83-97. doi: 10.1007/s12016-018-8723-y.
Emerging evidence suggests that the increasing prevalence of food allergies is associated with compositional and functional changes in our gut microbiota. Microbiota-host interactions play a key role in regulating the immune system. Development of a healthy gut microbiota and immune system occurs early in life and is largely shaped by exposure to maternal microbes through vaginal/natural delivery and breast milk, whereas use of antibiotics can disrupt gut homeostasis and significantly raise the risk of allergic diseases. Thus, changes in the quantity or diversity of gut microbes affect oral toleranace through interations of microbial molecules with pattern recognition receptors on immune cells and confer susceptibility to food allergies. On the other hand, short chain fatty acids which are fermentation end products of insoluble fibers by intestinal micoorganisms have been shown to confer protective effects on food allergy. As a preventive and therapeutic treatment for food allergies, probiotics have gained widespread attention in recent years. Reintroducing certain commensal microbes, such as Clostridia, both in animal models and clinical trials led to the prevention or resolution of allergic symptoms. This review highlights recent progress in our understanding of the gut microbiota's role in food allergy. However, mechanistic details underlying the anti-allergic effects of probiotics and the interaction between the gut microbiota and the immune system remain circumstantial and are not fully understood. Future studies should address possible factors and underlying mechanisms for microbiota-host interactions and gut immunity, as well as the efficacy, safety, and appropriate use of probiotics in establishing a standard treatment regimen for food allergies.
新出现的证据表明，食物过敏的患病率不断上升与我们肠道微生物群的组成和功能变化有关。微生物群与宿主的相互作用在调节免疫系统中起着关键作用。健康的肠道微生物群和免疫系统的发展发生在生命早期，主要通过阴道/自然分娩和母乳接触母体微生物来塑造，而抗生素的使用会破坏肠道平衡，并显著增加过敏疾病的风险。因此，肠道微生物的数量或多样性的变化会通过微生物分子与免疫细胞上的模式识别受体的相互作用影响口腔耐受性，并易患食物过敏。另一方面，短链脂肪酸是肠道微生物对不溶性纤维发酵的终产物，已被证明对食物过敏具有保护作用。作为食物过敏的预防和治疗方法，益生菌近年来受到广泛关注。在动物模型和临床试验中重新引入某些共生微生物，如梭状芽胞杆菌，可以预防或缓解过敏症状。这篇综述强调了我们对肠道微生物群在食物过敏中的作用的理解的最新进展。然而，益生菌的抗过敏作用的机制细节以及肠道微生物群与免疫系统之间的相互作用仍然是间接的，尚未完全理解。未来的研究应解决微生物群与宿主相互作用和肠道免疫的可能因素和潜在机制，以及益生菌在建立食物过敏标准治疗方案中的疗效、安全性和适当使用。
