1.
Food allergy and the gut.
Nowak-Wegrzyn, A, Szajewska, H, Lack, G
Nature reviews. Gastroenterology & hepatology. 2017;(4):241-257
Abstract
Food allergy develops as a consequence of a failure in oral tolerance, which is a default immune response by the gut-associated lymphoid tissues to ingested antigens that is modified by the gut microbiota. Food allergy is classified on the basis of the involvement of IgE antibodies in allergic pathophysiology, either as classic IgE, mixed pathophysiology or non-IgE-mediated food allergy. Gastrointestinal manifestations of food allergy include emesis, nausea, diarrhoea, abdominal pain, dysphagia, food impaction, protein-losing enteropathy and failure to thrive. Childhood food allergy has a generally favourable prognosis, whereas natural history in adults is not as well known. Elimination of the offending foods from the diet is the current standard of care; however, future therapies focus on gradual reintroduction of foods via oral, sublingual or epicutaneous food immunotherapy. Vaccines, modified hypoallergenic foods and modification of the gut microbiota represent additional approaches to treatment of food allergy.
2.
The prevention of food allergy in children.
Szajewska, H
Current opinion in clinical nutrition and metabolic care. 2013;(3):346-50
Abstract
PURPOSE OF REVIEW This article reports recent advances in early nutritional strategies used in the prenatal/postnatal periods for preventing allergies in children. RECENT FINDINGS Exclusive breastfeeding for 6 months is a desirable goal; however, with regard to allergy, the results of studies are inconsistent, showing a protective effect, no effect, or even a predisposing effect. For infants with a documented hereditary risk of allergy (i.e., an affected parent and/or sibling) who cannot be breastfed exclusively, dietary products with confirmed reduced allergenicity are recommended. Currently, there is no convincing scientific evidence that the avoidance or delayed introduction of potentially allergenic foods beyond 4-6 months reduces allergies in infants considered to be at increased risk for the development of allergic diseases or in those not considered to be at increased risk. The timing of n-3 long-chain polyunsaturated fatty acid supplementation may play a role in preventing early childhood allergy. Weak evidence from observational trials suggests a role of vitamins A, D, and E; zinc; fruit and vegetables; and a Mediterranean diet in the prevention of atopic disease. SUMMARY Current evidence challenges earlier dogma. Thus, more research, preferentially from randomized controlled trials, is needed with regard to evaluating the efficacy and safety of all nutritional interventions for allergy prevention.