Food allergy: Riding the second wave of the allergy epidemic

被引:372
|
作者
Prescott, Susan [1 ,2 ]
Allen, Katrina J. [3 ,4 ]
机构
[1] Princess Margaret Hosp Children, UWA Sch Paediat & Child Hlth Res, Perth, WA 6840, Australia
[2] Univ Western Australia, Sch Paediat & Child Hlth Res, Perth, WA 6009, Australia
[3] Royal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia
[4] Univ Melbourne, Melbourne, Vic, Australia
关键词
food allergy; allergic disease; allergy epidemic; allergy prevention; food allergens; INTERFERON-GAMMA PRODUCTION; IMMUNE-RESPONSES; NATURAL-HISTORY; ORAL TOLERANCE; PEANUT ALLERGY; TIME TRENDS; RISK-FACTOR; PHASE-III; PREVALENCE; ASTHMA;
D O I
10.1111/j.1399-3038.2011.01145.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Food allergy is a substantial and evolving public health issue, recently emerging over the last 10-15 yr as a 'second wave' of the allergy epidemic. It remains unclear why this new phenomenon has lagged decades behind the 'first wave' of asthma, allergic rhinitis and inhalant sensitization. In regions like Australia, which lead the respiratory epidemic, challenge-proven IgE-mediated food allergy now affects up to 10% of infants. Although their parents were among the first generation to experience the large-scale rise in allergic diseases, disorders of oral tolerance were previously uncommon. Of further concern, this new generation appears less likely to outgrow food allergy than their predecessors with long-term implications for disease burden. Allergic disease has been linked to the modern lifestyle including changing dietary patterns, changing intestinal commensal bacteria and vehicular pollution. It is not yet known whether the rise in food allergy is a harbinger of earlier and more severe effects of these progressive environmental changes or whether additional or unrelated lifestyle factors are implicated. New studies suggest environmental factors can produce epigenetic changes in gene expression and disease risk that may be potentially heritable across generations. The rising rates of maternal allergy, a strong direct determinant of allergic risk, could also be amplifying the effect of environmental changes. Preliminary evidence that non-Caucasian populations may be even more susceptible to the adverse effects of 'westernisation' has substantial global implications with progressive urbanization of the more populous regions in the developing world. Unravelling the environmental drivers is critical to curtail a potential tsunami of allergic disease.
引用
收藏
页码:155 / 160
页数:6
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