Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 145, Issue 5, Pages 1416-+Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2019.12.912
Keywords
House dust mite; food allergy; breast-feeding; protease
Categories
Funding
- Institut Thematique Multi-Organismes Immunologie, hematologie, pneumologie (IHP)-Circulation, metabolisme, nutrition (CMN) of the Institut National de la Sante et Recherche Medicale
- Universite de Nice Sophia Antipolis
- Fonds de Dotation ``Recherche en Sante Respiratoire''
- Societe Francaise d'Allergologie
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)-Comite francais d'Evaluation de la Cooperation universitaire et scientifique avec le Bresil (COFECUB) program [867/15]
- Larsson-Rosenquist Foundation
- University of Western Australia
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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. Objectives: This study sought to determine whether oral exposure to Dermatophagoides pteronyssinus through breast milk affects gut mucosal immunity with long-term effects on IgE-mediated food allergy susceptibility. 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 T(H)2 cell differentiation were found in gut mucosa of mice nursed by mothers exposed to D pteronyssinus compared with PBS. This pro-T(H)2 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.
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