关键词: Food allergy antigen presenting cell dendritic cell epicutaneous immunotherapy food allergy pathogenesis oral immunotherapy sublingual immunotherapy

来  源:   DOI:10.1016/j.jaci.2024.06.017

Abstract:
Food allergy is a growing problem with limited treatment options. It is important to understand the mechanisms of food tolerance and allergy to promote the development of directed therapies. Dendritic cells are specialized antigen presenting cells that prime adaptive immune responses, such as those involved in the development of oral tolerance and food allergies. The dendritic cell subsets in the gut and skin are defined by their surface markers and function. The default response to an ingested innocuous antigen is oral tolerance, which requires either gut dendritic cells or a subset of newly identified RORγt+ antigen presenting cells to induce the development of gut peripheral T regulatory cells. However, dendritic cells in the skin, gut, and lung can also promote allergic sensitization when they are activated under certain inflammatory conditions, such as with alarmin release or gut dysbiosis. Dendritic cells also play a role in the responses to the various modalities of food immunotherapy. Langerhans cells in the skin appear to be necessary for the response to epicutaneous immunotherapy. It will be important to determine which real-world stimuli activate the dendritic cells that prime allergic sensitization and discover methods to selectively initiate a tolerogenic program in antigen presenting cells.
摘要:
食物过敏是一个日益严重的问题,治疗选择有限。重要的是要了解食物耐受和过敏的机制,以促进定向疗法的发展。树突状细胞是专门的抗原呈递细胞,可以引发适应性免疫反应,例如那些参与口腔耐受性和食物过敏的发展。肠道和皮肤中的树突状细胞亚群由其表面标记和功能定义。对摄入的无害抗原的默认反应是口服耐受性,这需要肠道树突状细胞或新鉴定的RORγt抗原呈递细胞的子集来诱导肠道外周T调节细胞的发育。然而,皮肤中的树突状细胞,gut,gut当它们在某些炎症条件下被激活时,肺也可以促进过敏致敏,如alarmin释放或肠道菌群失调。树突状细胞在对食物免疫疗法的各种方式的反应中也起作用。皮肤中的朗格汉斯细胞似乎是对表皮免疫疗法的反应所必需的。重要的是确定哪些现实世界的刺激激活引发过敏性致敏的树突状细胞,并发现在抗原呈递细胞中选择性启动致耐受性程序的方法。
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