Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, Italy.
Int J Mol Sci. 2020 Feb 21;21(4):1474. doi: 10.3390/ijms21041474.
The improvement of the knowledge of the pathophysiological mechanisms underlying the tolerance and sensitization to food antigens has recently led to a radical change in the clinical approach to food allergies. Epidemiological studies show a global increase in the prevalence of food allergy all over the world and manifestations of food allergy appear increasingly frequent also in elderly subjects. Environmental and nutritional changes have partly changed the epidemiology of allergic reactions to foods and new food allergic syndromes have emerged in recent years. The deepening of the study of the intestinal microbiota has highlighted important mechanisms of immunological adaptation of the mucosal immune system to food antigens, leading to a revolution in the concept of immunological tolerance. As a consequence, new prevention models and innovative therapeutic strategies aimed at a personalized approach to the patient affected by food allergy are emerging. This review focuses on these new perspectives and their practical implications in the management of food allergy, providing an updated view of this complex pathology.
近年来,对食物抗原耐受和致敏的病理生理机制的认识不断提高,这使得食物过敏的临床治疗方法发生了根本性变化。流行病学研究表明,全球食物过敏的患病率正在上升,老年人群中食物过敏的表现也越来越频繁。环境和营养的变化部分改变了食物过敏反应的流行病学,近年来出现了一些新的食物过敏综合征。对肠道微生物群的深入研究揭示了黏膜免疫系统对食物抗原免疫适应性的重要机制,从而引发了对免疫耐受概念的变革。因此,新的预防模式和针对食物过敏患者的个性化治疗策略的创新治疗策略正在出现。这篇综述重点介绍了这些新视角及其在食物过敏管理中的实际意义,为这一复杂病理提供了最新的认识。