Section of Rheumatology, Allergy and Immunology, Department of Medicine, Yale University School of Medicine, New Haven, Conn.
Department of Immunobiology, Yale University School of Medicine, New Haven, Conn.
J Allergy Clin Immunol. 2024 Sep;154(3):511-522. doi: 10.1016/j.jaci.2024.06.017. Epub 2024 Jul 5.
Food allergy is a growing problem with limited treatment options. It is important to understand the mechanisms of food tolerance and allergy to promote the development of directed therapies. Dendritic cells (DCs) are specialized antigen-presenting cells (APCs) that prime adaptive immune responses, such as those involved in the development of oral tolerance and food allergies. The DC subsets in the gut and skin are defined by their surface markers and function. The default response to an ingested innocuous antigen is oral tolerance, which requires either gut DCs or a subset of newly identified RORγt APCs to induce the development of gut peripheral regulatory T cells. However, DCs in the skin, gut, and lung can also promote allergic sensitization when they are activated under certain inflammatory conditions, such as with alarmin release or gut dysbiosis. DCs also play a role in the responses to the various modalities of food immunotherapy. Langerhans cells in the skin appear to be necessary for the response to epicutaneous immunotherapy. It will be important to determine which real-world stimuli activate the DCs that prime allergic sensitization and discover methods to selectively initiate a tolerogenic program in APCs.
食物过敏是一个日益严重的问题,但其治疗选择有限。了解食物耐受和过敏的机制对于促进靶向治疗的发展非常重要。树突状细胞(DCs)是专门的抗原提呈细胞(APCs),可启动适应性免疫反应,例如参与口服耐受和食物过敏的发展。肠道和皮肤中的 DC 亚群通过其表面标志物和功能来定义。对摄入的无害抗原的默认反应是口服耐受,这需要肠道 DC 或新鉴定的 RORγt APC 亚群之一来诱导肠道外周调节性 T 细胞的发育。然而,当皮肤、肠道和肺部的 DC 在特定炎症条件下被激活时,它们也可以促进过敏致敏,例如警报素释放或肠道菌群失调。DCs 在各种食物免疫治疗方法的反应中也发挥作用。皮肤中的朗格汉斯细胞似乎是对表皮免疫治疗反应所必需的。确定哪些实际刺激物激活了引发过敏致敏的 DC,并发现选择性在 APC 中启动耐受原性程序的方法将非常重要。
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