Document Detail

Oral tolerance, food allergy, and immunotherapy: implications for future treatment.
MedLine Citation:
PMID:  18410959     Owner:  NLM     Status:  MEDLINE    
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.
A Wesley Burks; Susan Laubach; Stacie M Jones
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-04-14
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  121     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-09     Completed Date:  2008-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1344-50     Citation Subset:  AIM; IM    
Department of Pediatrics, Division of Allergy and Immunology, Duke University Medical Center, Durham, NC 27710, USA.
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MeSH Terms
Administration, Oral
Administration, Sublingual
Allergens / administration & dosage
Clinical Trials as Topic
Desensitization, Immunologic / methods*
Food Hypersensitivity / immunology*,  prevention & control*
Immune Tolerance / immunology*
Reg. No./Substance:

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