原標(biāo)題：早期經(jīng)母乳接觸屋塵螨過敏原在IgE介導(dǎo)的食物過敏易感性中的作用
背景：要成功預(yù)防食物過敏，就必須找出影響早期口服食物抗原耐受能力的因素。
方法：本研究研究了哺乳期暴露于屋塵螨過敏原（Der p）、蛋白酶滅活的屋塵螨過敏原或PBS的2周齡小鼠的腸道免疫功能。 同時進(jìn)一步分析了對其他食物過敏原卵清蛋白（OVA）的口服耐受性。在一項(xiàng)概念驗(yàn)證研究中，測定了100份母乳樣本中的Der p 1和OVA水平，并評估了與1周歲時IgE介導(dǎo)的雞蛋過敏流行率的關(guān)系。
結(jié)果：與PBS相比，暴露于屋塵螨且母乳喂養(yǎng)的小鼠腸黏膜通透性、IL-33水平、2型固有淋巴細(xì)胞活化和TH2細(xì)胞分化均增加。這種TH2腸道粘膜環(huán)境抑制了抗原特異性FoxP3調(diào)節(jié)性T細(xì)胞的誘導(dǎo)和通過母乳中的OVA暴露預(yù)防食物過敏。而蛋白酶滅活的屋塵螨過敏原對后代腸道黏膜免疫無影響。基于人類母乳中存在Der p 1和/或OVA，我們確定了哺乳期母親的群體，這與在小鼠身上發(fā)現(xiàn)導(dǎo)致不同雞蛋過敏風(fēng)險的因素一致。 
結(jié)論：這項(xiàng)研究強(qiáng)調(diào)了一個不可預(yù)測的食物過敏的潛在危險因素，即母乳中的屋塵螨過敏原，它破壞腸道免疫穩(wěn)態(tài)，并通過其蛋白酶活性抑制對其他食物抗原的口服耐受誘導(dǎo)。


延伸閱讀
JACI
A role for early oral exposure to house dust mite allergens through breast milk in IgE-mediated food allergy susceptibility
DOI: 10.1016/j.jaci.2019.12.912 
Abstract:
Background: Successful prevention of food allergy requires the identification of the factors adversely affecting the capacity to develop oral tolerance to food antigen in early life. 
Methods: Gut immunity was explored in 2-week-old mice breast-fed by mothers exposed to D pteronyssinus, protease-inactivated D pteronyssinus, or to PBS during lactation. We further analyzed oral tolerance to a bystander food allergen, ovalbumin (OVA). In a proof-of-concept study, Der p 1 and OVA levels were determined in 100 human breast milk samples and the association with prevalence of IgE-mediated egg allergy at 1 year was assessed.
Results: Increased permeability, IL-33 levels, type 2 innate lymphoid cell activation, and TH2 cell differentiation were found in gut mucosa of mice nursed by mothers exposed to D pteronyssinus compared with PBS. This pro-TH2 gut mucosal environment inhibited the induction of antigen-specific FoxP3 regulatory T cells and the prevention of food allergy by OVA exposure through breast milk. In contrast, protease-inactivated D pteronyssinus had no effect on offspring gut mucosal immunity. Based on the presence of Der p 1 and/or OVA in human breast milk, we identified groups of lactating mothers, which mirror the ones found in mice to be responsible for different egg allergy risk.
Conclusions: This study highlights an unpredicted potential risk factor for the development of food allergy, that is, D pteronyssinus allergens in breast milk, which disrupt gut immune homeostasis and prevents oral tolerance induction to bystander food antigen through their protease activity.
First Author:
Akila Rekima
Correspondence:
School of Molecular Sciences, University of Western Australia, M310, Perth WA 6009, Australia.
All Authors:
Akila Rekima, Chrystelle Bonnart, Patricia Macchiaverni, Jessica Metcalfe, Meri K. Tulic, Nicolas Halloin, Samah Rekima, Jon Genuneit, Samantha Zanelli, Samara Medeiros, Debra J. Palmer, Susan Prescott, Valerie Verhasselt
2020-09-14 Article
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺。