Section of Allergy and Immunology, University of Colorado Denver School of Medicine, Children's Hospital Colorado, Colorado.
Imperial College, London, UK.
Allergy. 2019 Aug;74(8):1429-1444. doi: 10.1111/all.13764. Epub 2019 May 3.
The prevalence of allergic diseases such as allergic rhinitis, asthma, food allergy, and atopic dermatitis has increased dramatically during the last decades, which is associated with altered environmental exposures and lifestyle practices. The purpose of this review was to highlight the potential role for dietary fatty acids, in the prevention and management of these disorders. In addition to their nutritive value, fatty acids have important immunoregulatory effects. Fatty acid-associated biological mechanisms, human epidemiology, and intervention studies are summarized in this review. The influence of genetics and the microbiome on fatty acid metabolism is also discussed. Despite critical gaps in our current knowledge, it is increasingly apparent that dietary intake of fatty acids may influence the development of inflammatory and tolerogenic immune responses. However, the lack of standardized formats (ie, food versus supplement) and standardized doses, and frequently a lack of prestudy serum fatty acid level assessments in clinical studies significantly limit our ability to compare allergy outcomes across studies and to provide clear recommendations at this time. Future studies must address these limitations and individualized medical approaches should consider the inclusion of specific dietary factors for the prevention and management of asthma, food allergy, and atopic dermatitis.
在过去几十年中，过敏性疾病（如过敏性鼻炎、哮喘、食物过敏和特应性皮炎）的患病率显著增加，这与环境暴露和生活方式的改变有关。本综述的目的是强调膳食脂肪酸在这些疾病的预防和治疗中的潜在作用。除了营养价值外，脂肪酸还具有重要的免疫调节作用。本文总结了脂肪酸相关的生物学机制、人类流行病学和干预研究。还讨论了遗传和微生物组对脂肪酸代谢的影响。尽管我们目前的知识存在重大差距，但越来越明显的是，膳食脂肪酸的摄入可能会影响炎症和耐受免疫反应的发展。然而，临床研究中缺乏标准化的格式（即食物与补充剂）和标准化的剂量，以及经常缺乏研究前血清脂肪酸水平评估，这极大地限制了我们在研究之间比较过敏结果并提供明确建议的能力。未来的研究必须解决这些限制，个体化的医疗方法应考虑包括特定的饮食因素，以预防和管理哮喘、食物过敏和特应性皮炎。
