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J Allergy Clin Immunol. 2018 Jan;141(1):11-19. doi: 10.1016/j.jaci.2017.11.005.

Mechanisms of food allergy.

Author information

1
The Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: hugh.sampson@mssm.edu.
2
Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
3
Department of Pediatrics, University of North Carolina, Chapel Hill, NC.
4
National Institute of Allergy and Infectious Diseases, Bethesda, Md.
5
Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

Abstract

Although oral tolerance is the normal physiologic response to ingested antigens, a breakdown in this process appears to have occurred in the past 2 decades, leading to an increasing prevalence of sensitization to food allergens. Over the past decade, basic research has intensified in an attempt to better understand the mechanisms leading to sensitization and disease versus desensitization and short- and long-term tolerance. In this review we assess various factors that can influence tissue and immune responses to food antigens, the current understanding of immune tolerance development, the role of the gastrointestinal microbiota, and current knowledge regarding immunologic mechanisms involved in desensitization and sustained unresponsiveness, although perhaps the latter is more appropriately termed remission.

KEYWORDS:

Food allergy; allergen immunotherapy; desensitization; microbiota; remission; sensitization; sustained unresponsiveness; tolerance

PMID:
29307410
DOI:
10.1016/j.jaci.2017.11.005

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