IgE-mediated food allergy (IgE-FA) occurs due to a breakdown in immune tolerance that leads to a detrimental type 2 helper T cell (TH2) adaptive immune response. While the processes governing this loss of tolerance are incompletely understood, several host-related and environmental factors impacting the risk of IgE-FA development have been identified. Mounting evidence supports the role of an impaired epithelial barrier in the development of IgE-FA, with exposure of allergens through damaged skin and gut epithelium leading to the aberrant production of alarmins and activation of TH2-type allergic inflammation. The treatment of IgE-FA has historically been avoidance with acute management of allergic reactions, but advances in allergen-specific immunotherapy and the development of biologics and other novel therapeutics are rapidly changing the landscape of food allergy treatment. Here, we discuss the pathogenesis and immunobiology of IgE-FA in addition to its diagnosis, prognosis, and treatment.Expected final online publication date for the Annual Review of Immunology, Volume 42 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

中文翻译：

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食物过敏的免疫生物学和治疗

IgE 介导的食物过敏 (IgE-FA) 是由于免疫耐受破坏导致有害的 2 型辅助 T 细胞 (TH2）适应性免疫反应。虽然控制这种耐受性丧失的过程尚不完全清楚，但已经确定了一些影响 IgE-FA 发展风险的宿主相关因素和环境因素。越来越多的证据支持受损的上皮屏障在 IgE-FA 形成中的作用，通过受损的皮肤和肠道上皮暴露过敏原，导致警报素的异常产生和 T 细胞的激活H2型过敏性炎症。历史上，IgE-FA 的治疗一直是通过过敏反应的急性治疗来避免，但过敏原特异性免疫疗法的进步以及生物制剂和其他新型疗法的发展正在迅速改变食物过敏治疗的格局。在这里，我们讨论 IgE-FA 的发病机制和免疫生物学，以及其诊断、预后和治疗。《免疫学年度评论》第 42 卷的预计最终在线出版日期为 2024 年 4 月。请参阅 http://www.annualreviews .org/page/journal/pubdates 了解修订后的估计。