Division of Allergy, Bambino Gesù Children's Hospital IRCCS.
NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy.
Curr Opin Allergy Clin Immunol. 2020 Jun;20(3):323-328. doi: 10.1097/ACI.0000000000000644.
To perform a nonsystematic review of the literature on the microbiota in the different types of non-IgE-mediated food allergy.
The commonest non-IgE-mediated disorders managed by allergists include: eosinophilic esophagitis, food protein-induced enteropathy, food protein-induced enterocolitis syndrome, and food protein-induced allergic proctocolitis. The review of the literature describes how at phylum level we observe an increase of Proteobacteria in eosinophilic esophagitis esophageal microbiota and in food protein-induced enterocolitis syndrome, and food protein-induced allergic proctocolitis gut microbiota, while we observe an increase of Bacteroidetes in healthy controls. Several studies endorse the concept that a bloom of Proteobacteria in the gut reflects dysbiosis or an unstable gut microbial community structure. In several studies, the type of diet, the use of probiotics and in a single experience the use of fecal microbiota transplantation has produced significant variations of the microbiota.
Genetic factors alone cannot account for the rapid rise in food allergy prevalence and the microbiome might be contributing to allergy risk. Our review showed that common features of the pathological microbiota among different types of non-IgE-mediated food allergy can be identified. These evidences suggest a possible role of the microbiota in the pathogenesis and non-IgE-mediated food allergies and the need to understand the effects of its modulation on the disorders themselves.
对非 IgE 介导的食物过敏的不同类型中微生物群的文献进行非系统性综述。
过敏症专家管理的最常见的非 IgE 介导的疾病包括：嗜酸性食管炎、食物蛋白诱导的肠病、食物蛋白诱导的肠病综合征和食物蛋白诱导的过敏性直肠结肠炎。文献综述描述了在门水平上，我们观察到嗜酸性食管炎食管微生物群和食物蛋白诱导的肠病综合征和食物蛋白诱导的过敏性直肠结肠炎肠道微生物群中变形菌门的增加，而在健康对照组中我们观察到拟杆菌门的增加。一些研究证实了这样一种概念，即肠道中变形菌门的大量繁殖反映了菌群失调或不稳定的肠道微生物群落结构。在几项研究中，饮食类型、益生菌的使用以及在单次粪便微生物群移植的经验中，微生物群发生了显著变化。
仅遗传因素不能解释食物过敏流行率的迅速上升，而微生物组可能会增加过敏风险。我们的综述表明，可以确定不同类型的非 IgE 介导的食物过敏之间病理微生物群的共同特征。这些证据表明，微生物群可能在发病机制和非 IgE 介导的食物过敏中发挥作用，并且需要了解其调节对自身疾病的影响。
