Suaini, N. H. A., Siah, K. T. H., Tham, E. H. (2021). Role of the gut–skin axis in IgE-mediated food allergy and atopic diseases. Current Opinion in Gastroenterology, 37(6), 557–564. doi:10.1097/mog.0000000000000780
Abstract:
Purpose of review
In recent years, landmark clinical trials investigating the role of early oral exposure to food antigens for food allergy (FA) prevention have highlighted the importance of immunoregulatory pathways in the “gut-skin axis”. This review highlights recent literature on the mechanisms of the immune system and microbiome involved in the gut-skin axis, contributing to the development of atopic dermatitis (AD), food allergy (FA), allergic rhinitis (AR) and asthma. Therapeutic interventions harnessing the gut-skin axis are also discussed.
Recent findings
Epicutaneous sensitization in the presence of AD is capable of inducing Th2 allergic inflammation in the intestinal tract and lower respiratory airways, predisposing one to the development of allergic rhinitis (AR) and asthma. Probiotics have demonstrated positive effects in preventing and treating AD, though there is no evident relationship of its beneficial effects on other allergic diseases. Prophylactic skin emollients use has not shown consistent protection against AD, while there is some evidence for the role of dietary changes in alleviating AD and airway inflammation. More RCTs are needed to clarify the potential of epicutaneous immunotherapy as a therapeutic strategy for patients with FA.
Summary
The growing understanding of the gut-skin interactions on allergic disease pathogenesis present novel avenues for therapeutic interventions which target modulation of the gut and/or skin.
License type:
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Funding Info:
This research / project is supported by the National Medical Research Council - Transition Award
Grant Reference no. : MOH-TA18nov-003
Description:
This is a non-final version of an article published in final form in Suaini, N. H. A., Siah, K. T. H., & Tham, E. H. (2021). Role of the gut–skin axis in IgE-mediated food allergy and atopic diseases. Current Opinion in Gastroenterology, 37(6), 557–564. doi:10.1097/mog.0000000000000780