Published online: November 14, 2017
Food allergy resolves in a significant percentage of food allergic children without intervention. However, the underlying mechanisms governing the persistence or resolution of food allergy in childhood are not understood. Recent work suggests a role for the innate immune system in the development of allergic disease, including evidence that heightened inflammatory responses at birth predispose to the development of food allergy in infancy. It remained unclear whether these responses persisted into postnatal life and whether innate immune function plays a role in the persistence or resolution of food allergy.
In an original manuscript recently published in The Journal of Allergy and Clinical Immunology (JACI), Neeland and colleagues hypothesized that innate immune function in the first year of life determines food allergy outcomes in childhood. They analyzed longitudinally collected blood samples from a cohort of challenge confirmed egg allergic one-year-old infants whose egg allergy either persisted or naturally resolved in childhood to determine if innate immune function in the first year of life is distinct between the clinical phenotypes of egg allergy.
The results show that infants with persistent egg allergy demonstrated a unique innate immune signature in the first year of life. Persistent food allergy was characterized by increased numbers of circulating innate cells that produce more inflammatory mediators both at baseline and following endotoxin exposure. This unique innate immune signature continues into childhood in those with persistent egg allergy. Moreover, it appeared that increased levels of serum vitamin D correlated with changes in innate immune profiles observed in children who developed natural tolerance to egg.
These findings suggest that early life innate immune dysfunction may represent a key immunological driver and predictor of persistent food allergy in childhood, and that serum vitamin D may play an important immune-modulatory role in the development of natural tolerance.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.