NDLI: Oral tolerance, food allergy, and immunotherapy: implications for future treatment.

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Oral tolerance, food allergy, and immunotherapy: implications for future treatment.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Burks, A. Wesley Laubach, Susan Jones, Stacie M.
Description	Country affiliation: United States Author Affiliation: Burks AW ( Department of Pediatrics, Division of Allergy and Immunology, Duke University Medical Center, Durham, NC 27710, USA. wesley.burks@duke.edu)
Abstract	The lumen of the gastrointestinal tract is exposed daily to an array of dietary proteins. The vast majority of proteins are tolerated through suppression of cellular or humoral responses, a process known as oral tolerance. However, in approximately 6% of children and 4% of adults in the United States, tolerance to a given dietary antigen either is not established or breaks down, resulting in food hypersensitivity. Although food allergies can result in sudden and life-threatening symptoms, their prevalence is remarkably low considering the complexities of the gut-associated mucosal system. Suppression involves signaling by an array of nonprofessional antigen-presenting cells, dendritic cells, and regulatory T cells, as well as lymphocyte anergy or deletion. Several factors, including antigen properties, route of exposure, and genetics and age of the host, contribute to the development of oral tolerance. Although the current standard of care for patients with food allergies is based on avoidance of the trigger, increased understanding of the mechanisms involved in tolerance has shifted focus of treatment and prevention toward inducing tolerance. Data from early-phase clinical trials suggest both sublingual and oral immunotherapy are effective in reducing sensitivity to allergens. In this article we review the mechanisms of tolerance, discuss aberrations in oral tolerance, and provide information on novel prevention and treatment paradigms for food allergy.
File Format	HTM / HTML
ISSN	00916749
e-ISSN	10976825
Journal	Journal of Allergy and Clinical Immunology
Issue Number	6
Volume Number	121
Language	English
Publisher	Elsevier
Publisher Date	2008-06-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Immunology Desensitization, Immunologic Food Hypersensitivity Immunology Prevention & Control Immune Tolerance Administration, Oral Administration, Sublingual Allergens Administration & Dosage Animals Clinical Trials As Topic
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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