Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented?

被引:184
作者
Brough, Helen A. [1 ,2 ,3 ]
Nadeau, Kari C. [4 ,5 ,6 ]
Sindher, Sayantani B. [4 ,5 ]
Alkotob, Shifaa S. [4 ,5 ]
Chan, Susan [1 ,2 ,3 ]
Bahnson, Henry [7 ]
Leung, Donald Y. M. [8 ]
Lack, Gideon [1 ,2 ,3 ]
机构
[1] Kings Coll London, St Thomas Hosp, Sch Life Course Sci, Paediat Allergy Grp,Dept Women & Childrens Hlth, London, England
[2] Kings Coll London, Paediat Allergy Grp, Peter Gorer Dept Immunobiol, Sch Immunol & Microbial Sci,Guys Hosp, London, England
[3] Guys & St Thomas Hosp NHS Fdn Trust, Evelina Childrens Hosp, Childrens Allergy Serv, 2nd Floor,Stairwell B,South Wing, London SE1 7EH, England
[4] Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA
[5] Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA
[6] Stanford Univ, Dept Med, Div Allergy Immunol & Rheumatol, Stanford, CA 94305 USA
[7] Benaroya Res Inst & Immune Tolerance Network, Seattle, WA USA
[8] Natl Jewish Hlth, Dept Pediat, Div Pediat Allergy Immunol, Denver, CO USA
基金
美国国家卫生研究院; 英国医学研究理事会; 英国惠康基金;
关键词
atopic dermatitis; cutaneous sensitization; emollient; filaggrin gene; food allergy; THYMIC STROMAL LYMPHOPOIETIN; TRANSEPIDERMAL WATER-LOSS; OF-FUNCTION MUTATIONS; SKIN BARRIER FUNCTION; HOUSEHOLD PEANUT CONSUMPTION; INDUCED TH2 RESPONSES; ATOPIC-DERMATITIS; MAST-CELLS; T-CELLS; FUNCTION VARIANTS;
D O I
10.1111/all.14304
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
There is increasing evidence regarding the importance of allergic sensitization through the skin. In this review, we provide an overview of the atopic march and immune mechanism underlying the sensitization and effector phase of food allergy. We present experimental models and human data that support the concept of epicutaneous sensitization and how this forms one half of the dual-allergen exposure hypothesis. We discuss specific important elements in the skin (FLG and other skin barrier gene mutations, Langerhans cells, type 2 innate lymphoid cells, IL-33, TSLP) that have important roles in the development of allergic responses as well as the body of evidence on environmental allergen exposure and how this can sensitize an individual. Given the link between skin barrier impairment, atopic dermatitis, food allergy, allergic asthma, and allergic rhinitis, it is logical that restoring the skin barrier and prevention or treating atopic dermatitis would have beneficial effects on prevention of related allergic diseases, particularly food allergy. We present the experimental and human studies that have evaluated this approach and discuss various factors which may influence the success of these approaches, such as the type of emollient chosen for the intervention, the role of managing skin inflammation, and differences between primary and secondary prevention of atopic dermatitis to achieve the desired outcome.
引用
收藏
页码:2185 / 2205
页数:21
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