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Early intervention and prevention of allergic diseases
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  • Brough H.A.,
  • Bruce Lanser,
  • Sayantani Sindher,
  • Joyce Teng,
  • Donald Leung,
  • Carina Venter,
  • Chan S.M.,
  • Alexandra Santos,
  • Henry Bahnson,
  • Guttman-Yassky E.,
  • Ruchi Gupta,
  • Gideon Lack,
  • Ciaccio C.,
  • Vanitha Sampath,
  • Kari Nadeau,
  • Cathryn Nagler
Brough H.A.
King's College London Faculty of Life Sciences and Medicine
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Bruce Lanser
National Jewish Health Division of Allergy & Clinical Immunology
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Sayantani Sindher
Stanford University
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Joyce Teng
Lucile Salter Packard Children's Hospital at Stanford
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Donald Leung
National Jewish Health Division of Allergy & Clinical Immunology
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Carina Venter
University of Colorado - Anschutz Medical Campus
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Chan S.M.
King's College London Faculty of Life Sciences and Medicine
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Alexandra Santos
King's College London Faculty of Life Sciences and Medicine
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Henry Bahnson
Benaroya Research Institute at Virginia Mason
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Guttman-Yassky E.
Icahn School of Medicine at Mount Sinai Department of Medicine
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Ruchi Gupta
Northwestern University Feinberg School of Medicine
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Gideon Lack
King's College London Faculty of Life Sciences and Medicine
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Ciaccio C.
The University of Chicago
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Vanitha Sampath
Stanford University
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Kari Nadeau
Stanford University
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Cathryn Nagler
The University of Chicago
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Abstract

Food Allergy (FA) is now one of the most common chronic diseases of childhood often lasting throughout life and leading to significant worldwide healthcare burden. The precise mechanisms responsible for the development of this inflammatory condition are largely unknown; however, a multifactorial aetiology involving both environmental and genetic contributions is well accepted. A precise understanding of the pathogenesis of FA is an essential first step to developing comprehensive prevention strategies that could mitigate this epidemic. As it is frequently preceded by atopic dermatitis and can be prevented by early antigen introduction, the development of FA is likely facilitated by the improper initial presentation of antigen to the developing immune system. Primary oral exposure of antigens allowing for presentation via a well-developed mucosal immune system, rather than through a disrupted skin epidermal barrier, is essential to prevent FA. In this review, we present the data supporting the necessity of 1) an intact epidermal barrier to prevent epicutaneous antigen presentation, 2) the presence of specific commensal bacteria to maintain an intact mucosal immune system and 3) maternal/infant diet diversity, including vitamins and minerals, and appropriately timed allergenic food introduction to prevent FA.

Peer review status:ACCEPTED

23 Jun 2021Submitted to Allergy
24 Jun 2021Assigned to Editor
24 Jun 2021Submission Checks Completed
24 Jun 2021Reviewer(s) Assigned
09 Jul 2021Review(s) Completed, Editorial Evaluation Pending
09 Jul 2021Editorial Decision: Accept