Division of Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
Division of Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
J Allergy Clin Immunol. 2021 Mar;147(3):808-813. doi: 10.1016/j.jaci.2020.12.624. Epub 2020 Dec 22.
Food allergy (FA) is a significant public health issue, propelled by its rapidly increasing prevalence. Its sharp rise into prominence has focused attention on causative environmental factors and their interplay with the immune system in disease pathogenesis. In that regard, there is now substantial evidence that alterations in the gut microbiome early in life imprint the host gut mucosal immunity and may play a critical role in precipitating FA. These changes may impact key steps in the development of the infant gut microbiome, including its shaping by maternal factors and upon the introduction of solid food (the weaning reaction). These early-life changes may have long-range effects on host immunity that manifest later in time as disease pathology. Experimental studies have shown that resetting the host intestinal immune responses by treatment with either a healthy fecal microbiota transplantation or defined commensal bacterial taxa can prevent or treat FA. The mechanisms by which these interventions suppress FA include restoration of gut immune regulatory checkpoints, notably the retinoic orphan receptor gamma T regulatory T cells, the epithelial barrier, and healthy immunoglobulin A responses to the gut commensals. These findings inform human studies currently in progress that evaluate the role of microbial therapies in FA.
食物过敏(FA)是一个重大的公共卫生问题,其患病率迅速上升。它的急剧上升引起了人们对环境致病因素及其与免疫系统在疾病发病机制中的相互作用的关注。在这方面,现在有大量证据表明,生命早期肠道微生物组的改变会影响宿主肠道黏膜免疫,并可能在引发 FA 方面发挥关键作用。这些变化可能会影响婴儿肠道微生物组发育的关键步骤,包括母体因素和固体食物(断奶反应)对其的影响。这些早期生活的变化可能会对宿主免疫产生长期影响,随着时间的推移,这些影响会表现为疾病病理。实验研究表明,通过健康粪便微生物群移植或特定共生细菌类群治疗来重置宿主肠道免疫反应,可以预防或治疗 FA。这些干预措施抑制 FA 的机制包括恢复肠道免疫调节检查点,特别是视黄酸孤儿受体γ T 调节性 T 细胞、上皮屏障和对肠道共生菌的健康免疫球蛋白 A 反应。这些发现为目前正在进行的评估微生物疗法在 FA 中的作用的人类研究提供了信息。
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