Lukacs Nicholas W, Hogan Simon P
Division of Experimental Pathology, Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
Mary H Weiser Food Allergy Center, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
Nat Rev Immunol. 2025 Jun 26. doi: 10.1038/s41577-025-01185-y.
Food allergy is an acute IgE-mediated reaction that occurs in response to food components and affects 1-10% of the global population. It is often thought to be a disease of the gastrointestinal tract, in which oral exposure to a food allergen induces an IgE-sensitizing response that primes the host immune system to react to the eliciting allergen following subsequent oral exposure. However, emerging evidence from clinical and basic research studies suggests that maladaptive immune responses in the skin also contribute to the development of food allergy. These responses can promote the development of food-specific IgE and reshape the gut immune microenvironment in a manner that predisposes to IgE-mediated activation of mast cells and clinical manifestations of allergic disease following subsequent food exposures. In this Review, we discuss how different routes of exposure to food antigens can contribute to allergic sensitization and describe how mast cells ultimately drive the allergic reaction to these food allergens.
食物过敏是一种由免疫球蛋白E（IgE）介导的急性反应，由食物成分引发，影响全球1%至10%的人口。人们通常认为它是一种胃肠道疾病，口服食物过敏原会引发IgE致敏反应，使宿主免疫系统在随后口服引发性过敏原时做出反应。然而，临床和基础研究的新证据表明，皮肤中的适应性免疫反应也会导致食物过敏的发生。这些反应会促进食物特异性IgE的产生，并以一种使后续食物暴露后易引发IgE介导的肥大细胞激活和过敏性疾病临床表现的方式重塑肠道免疫微环境。在本综述中，我们将讨论不同的食物抗原暴露途径如何导致过敏致敏，并描述肥大细胞最终如何驱动对这些食物过敏原的过敏反应。
