A. Wesley Burks, MD, Susan Laubach, MD, Stacie M. Jones, MD

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Presentation transcript:

Oral tolerance, food allergy, and immunotherapy: Implications for future treatment A. Wesley Burks, MD, Susan Laubach, MD, Stacie M. Jones, MD Journal of Allergy and Clinical Immunology Volume 121, Issue 6, Pages 1344-1350 (June 2008) DOI: 10.1016/j.jaci.2008.02.037 Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Antigen sampling in the gut. A, Dendritic cells extend processes through the epithelium and into the lumen. B, M cells overlying Peyer's patches take up particulate antigens and deliver them to subepithelial dendritic cells. C, Soluble antigens possibly cross the epithelium through transcellular or paracellular routes to encounter T cells or macrophages in the lamina propria. Modified with permission from Chehade M, Mayer L. Oral tolerance and its relation to food hypersensitivities. J Allergy Clin Immunol 2005;115:3-12.7 Journal of Allergy and Clinical Immunology 2008 121, 1344-1350DOI: (10.1016/j.jaci.2008.02.037) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Mechanisms of oral tolerance. A, Immune responses require T-cell receptor ligation with peptide-MHC complexes in the presence of appropriate costimulatory molecules (CD80 and CD86) and cytokines. B, Low doses of antigen favor tolerance driven by regulatory cells, which suppress immune responses through soluble or cell surface–associated downregulatory cytokines, such as IL-4, IL-10, and TGF-β. C, High-dose tolerance is mediated by lymphocyte anergy or clonal deletion. Anergy can occur through T-cell receptor ligation in the absence of costimulatory signals. Clonal deletion occurs by means of FAS-mediated apoptosis (CD95). TCR, T-cell receptor; Ag, antigen. Modified with permission from Chehade M, Mayer L. Oral tolerance and its relation to food hypersensitivities. J Allergy Clin Immunol 2005;115:3-12.7 Journal of Allergy and Clinical Immunology 2008 121, 1344-1350DOI: (10.1016/j.jaci.2008.02.037) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions