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

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 suppor...

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Vydáno v:Allergy (Copenhagen) Ročník 75; číslo 9; s. 2185 - 2205
Hlavní autoři: Brough, Helen A., Nadeau, Kari C., Sindher, Sayantani B., Alkotob, Shifaa S., Chan, Susan, Bahnson, Henry T., Leung, Donald Y. M., Lack, Gideon
Médium: Journal Article
Jazyk:angličtina
Vydáno: Denmark Blackwell Publishing Ltd 01.09.2020
Témata:
Allergens
Allergic diseases
Allergic rhinitis
Asthma
Atopic dermatitis
cutaneous sensitization
Dermatitis
Dermatitis, Atopic - etiology
Dermatitis, Atopic - prevention & control
Eczema
emollient
filaggrin gene
Filaggrin Proteins
Food allergies
food allergy
Food Hypersensitivity - prevention & control
Humans
Immunity, Innate
Langerhans cells
Lymphocytes
Lymphoid cells
Skin
Thymic stromal lymphopoietin
filaggrin gene
atopic dermatitis
emollient
food allergy
cutaneous sensitization
ISSN:0105-4538, 1398-9995, 1398-9995
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Shrnutí: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.
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Dr Brough wrote the first draft and incorporated all subsequent changes to document and coordinated final version and submission. Dr Sindher and Dr Alkotob provided assistance with writing, review, references, figures and tables. Dr Nadeau, Dr Leung, Dr Lack, Dr Chan and Dr Bahnson provided assistance in writing and reviewing the manuscript.
Authors Brough and Nadeau are joint first authors and authors Leung and Lack are joint last authors.
Author contributions
ISSN:0105-4538
1398-9995
1398-9995
DOI:10.1111/all.14304