Markers of tolerance development to food allergens.
IgE-mediated reactions to food allergens are the most common cause of anaphylaxis in childhood. Although allergies to cow's milk, egg, or soy proteins, in contrast to peanut and tree nut allergens, resolve within the first 6 years of life in up to 60% due to natural tolerance development, this process is not well understood. At present, there is no cure or treatment for food allergy that would result in an induction of tolerance to the symptom-eliciting food. Avoidance, providing an emergency plan and education, is the standard of treatment. Oral immunotherapeutic approaches have been proven reasonable efficacy; however, they are associated with high rates of side-effects and low numbers of patients achieving tolerance. Nevertheless, mechanisms that take place during oral immunotherapy may help to understand tolerance development. On the basis of these therapeutic interventions, events like loss of basophil activation and induction of regulatory lymphocyte subsets and of blocking antibodies have been described. Their functional importance at a clinical level, however, remains to be investigated in detail. Consequently, there is eminent need to understand the process of tolerance development to food allergens and define biomarkers to develop and monitor new treatment strategies for food allergy.
Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
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Ponce
Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
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Diesner
Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
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Szépfalusi
Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. thomas.eiwegger@sickkids.ca.|Division of Immunology and Allergy, Food allergy and Anaphylaxis Program, The Department of Paediatrics, Hospital for Sick Children, Research Institute, Physiology and Experimental Medicine Program, The University of Toronto, Toronto, ON, Canada. thomas.eiwegger@sickkids.ca.
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Eiwegger
D000485:Allergens / Q000276:immunology*; D000818:Animals; D015415:Biomarkers; D003888:Desensitization, Immunologic; D004195:Disease Models, Animal; D005260:Female; D005502:Food / Q000009:adverse effects*; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007108:Immune Tolerance; D018928:Immunity, Mucosal; D007114:Immunization; D007073:Immunoglobulin E / Q000276:immunology; D018811:Maternal Exposure; D051379:Mice; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000276:immunology
D000485:Allergens; D015415:Biomarkers; D007073:Immunoglobulin E
food allergens; food allergy; marker; oral immunotherapy; tolerance