Center for Environmental Medicine, Asthma and Lung Biology.
Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA.
Curr Opin Allergy Clin Immunol. 2023 Apr 1;23(2):164-171. doi: 10.1097/ACI.0000000000000889. Epub 2023 Jan 11.
The increasing global prevalence of food allergy indicates that environmental exposures are likely contributing to food allergy development. This review summarizes recent studies on how specific factors within the external exposome may impact the development of food allergy.
There is strong evidence that nonoral exposure to food allergens within the living environment is a risk factor for food sensitization and food allergy. The role of air pollution in food allergy development remains unclear, as cohort studies have not found consistent relationships between air pollutant exposure and food sensitization. Early-life microbial exposures linked to a rural lifestyle are likely protective against food allergy development, possibly through alteration of the infant microbiome. In contrast, factors associated with urbanization and decreased exposure to microbes may contribute to food allergy development. Recent studies on the role of residential greenness in food allergy development suggest either no relationship or a possible increased risk for food allergy.
The external exposome comprises a number of exposures that can modify food allergy risk. Improved understanding of how complex environmental exposures interact with genetic factors will be necessary for developing effective interventions aimed at preventing food allergy development in children.
食物过敏的全球患病率不断增加表明，环境暴露可能是导致食物过敏发展的原因。本综述总结了近期关于外部暴露组内特定因素如何影响食物过敏发展的研究。
有强有力的证据表明，生活环境中非口服接触食物过敏原是食物致敏和食物过敏的危险因素。空气污染在食物过敏发展中的作用仍不清楚，因为队列研究并未发现空气污染物暴露与食物致敏之间存在一致的关系。与农村生活方式相关的早期生命微生物暴露可能具有保护作用，防止食物过敏的发展，可能是通过改变婴儿的微生物组。相比之下，与城市化和减少微生物接触相关的因素可能导致食物过敏的发展。最近关于居住绿化在食物过敏发展中的作用的研究表明，两者之间没有关系，或者食物过敏的风险可能增加。
外部暴露组包含许多可改变食物过敏风险的暴露因素。为了开发旨在预防儿童食物过敏发展的有效干预措施，需要更好地了解复杂的环境暴露如何与遗传因素相互作用。
