Background

Food allergy naturally resolves in a proportion of food-allergic children without intervention; however the underlying mechanisms governing the persistence or resolution of food allergy in childhood are not understood.

Objectives

This study aimed to define the innate immune profiles associated with egg allergy at age 1 year, determine the phenotypic changes that occur with the development of natural tolerance in childhood, and explore the relationship between early life innate immune function and serum vitamin D.

Methods

This study used longitudinally collected PBMC samples from a population-based cohort of challenge-confirmed egg-allergic infants with either persistent or transient egg allergy outcomes in childhood to phenotype and quantify the functional innate immune response associated with clinical phenotypes of egg allergy.

Results

We show that infants with persistent egg allergy exhibit a unique innate immune signature, characterized by increased numbers of circulating monocytes and dendritic cells that produce more inflammatory cytokines both at baseline and following endotoxin exposure when compared with infants with transient egg allergy. Follow-up analysis revealed that this unique innate immune signature continues into childhood in those with persistent egg allergy and that increased serum vitamin D levels correlate with changes in innate immune profiles observed in children who developed natural tolerance to egg.

Conclusions

Early life innate immune dysfunction may represent a key immunological driver and predictor of persistent food allergy in childhood. Serum vitamin D may play an immune-modulatory role in the development of natural tolerance.

中文翻译：

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持续性食物过敏的早期生命先天免疫特征

背景

在没有干预的情况下，一部分食物过敏的儿童自然可以解决食物过敏；然而，尚不清楚控制儿童食物过敏持续或消退的潜在机制。

目标

这项研究旨在确定与1岁时鸡蛋变态反应相关的先天免疫特征，确定随着童年自然耐受性的发展而发生的表型变化，并探讨早期生命的先天免疫功能与血清维生素D的关系。

方法

这项研究使用了纵向收集的PBMC样本，这些样本来自儿童期具有持续性或短暂性鸡蛋过敏结果的，经挑战确认的鸡蛋过敏婴儿，以进行表型分析并量化与鸡蛋过敏临床表型相关的先天性免疫反应。

结果

我们显示，具有持续性鸡蛋过敏的婴儿与短暂性鸡蛋过敏的婴儿相比，表现出独特的先天免疫特征，其特征是循环单核细胞和树突状细胞数量增加，在基线和内毒素暴露后均产生更多的炎性细胞因子。后续分析显示，这种对鸡蛋持续过敏的人，这种独特的先天免疫特征一直延续到童年，而血清维生素D水平的升高与对卵具有天然耐受性的儿童中观察到的先天免疫特征的变化相关。

结论

生命早期的先天性免疫功能障碍可能是儿童时期持续性食物过敏的关键免疫学驱动因素和预测因子。血清维生素D可能在自然耐受性的发展中起到免疫调节作用。