Abstract
The development of food allergies is thought to involve multiple factors, and it is unclear which conveys the most risk regarding this process. Since food allergy is a chronic disease without a cure at this time, understanding its development could provide an avenue for preventive practices and development of a curative treatment. Both historical and current data implicate maternal factors, genetics, and environmental exposures as major risk factors in the development of food allergy. An immature gut of the infant has been hypothesized as a possible route of sensitization. Breastfeeding until at least 6 months of age has been shown to have protective factors for the newborn and may possibly improve gut permeability. Newer studies such as the LEAP and EAT investigations also looked at early exposure and prevention of food allergies; their long-term results are critical in understanding early introduction and tolerance. Cutaneous exposure, oral exposure, and food protein exposure in house dust with their relation to the food allergy course are also a path of interest. Current research has shown sensitization can occur through impaired skin such as those with eczema and a filaggrin mutation. Tropomyosin and alpha-gal also are related to the complicated immunomodulatory factors involved in food allergy and allergic response. Cross-reactivity with plant allergens, sensitization to house dust mite and cockroach, and lone star tick bites can also induce food allergens in children and adults. Together, these factors provide a cohesive beginning to understanding how food allergies can occur and can influence further investigation into prevention, treatment, and eventual cure of food allergies.
Similar content being viewed by others
References
Sicherer S, Sampson H (2014) Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol 133(2):291–307 quiz 308
Perkin M, Logan K, Tseng A, Raji B, Ayis S, Peacock J, Brough H, Marrs T, Radulovic S, Craven J, Flohr C, Lack G, EAT Study Team (2016) Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med 374(18):1733–1743
Grulee C, Sanford H (1936) The influence of breast and artificial feeding on infantile eczema. J Pediatr 9(2):223–225
Sicherer S (2002) The impact of maternal diets during breastfeeding on the prevention of food allergy. Curr Opin Allergy Clin Immunol 2(3):207–210
Munblit D, Verhasselt V (2016) Allergy prevention by breastfeeding: possible mechanisms and evidence from human cohorts. Curr Opin Allergy Clin Immunol 16(5):427–433
Newburg D, Walker W (2007) Protection of the neonate by the innate immune system of developing gut and of human milk. Pediatr Res 61(1):2–8
Kusunoki T, Morimoto M et al (2010) Breastfeeding and the prevalence of allergic diseases in schoolchildren: does reverse causation matter? Pediatr Allergy Immunol 21(1 Pt 1):60–66
Falth-Magnusson K, Kjellman N (1992) Allergy prevention by maternal elimination diet during late pregnancy—a 5-year follow-up of a randomized study. J Allergy Clin Immunol 89(3):709–713
Frank L, Marian A, Visser M, Weinberg E, Potter PC (1999) Exposure to peanuts in utero and in infancy and the development of sensitization to peanut allergens in young children. Pediatr Allergy Immunol 10(1):27–32
Kramer M, Kakuma R (2012) Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev 9:CD000133
Hourihane J, Dean T et al (1996) Peanut allergy in relation to heredity, maternal diet, and other atopic diseases: results of a questionnaire survey, skin prick testing, and food challenges. BMJ 313(7056):518–521
Jarvinen K, Westfall J et al (2015) Role of maternal dietary peanut exposure in development of food allergy and oral tolerance. PLoS One 10(12):e0143855
Chmielewska A, Piescik-Lech M et al (2017) Systematic review: early infant feeding practices and the risk of wheat allergy. J Paediatr Child Health 53(9):889–896
Jarvinen K, Westfall J et al (2014) Role of maternal elimination diets and human milk IgA in the development of cow’s milk allergy in the infants. Clin Exp Allergy 44(1):69–78
Hattevig G, Kjellman B et al (1989) Effect of maternal avoidance of eggs, cow’s milk and fish during lactation upon allergic manifestations in infants. Clin Exp Allergy 19(1):27–32
Hattevig G, Sigurs N, Kjellman B (1999) Effects of maternal dietary avoidance during lactation on allergy in children at 10 years of age. Acta Paediatr 88(1):7–12
Sigurs N, Hattevig G, Kjellman B (1992) Maternal avoidance of eggs, cow’s milk, and fish during lactation: effect on allergic manifestations, skin-prick tests, and specific IgE antibodies in children at age 4 years. Pediatrics 89(4 Pt 2):735–739
Hide D, Matthews S et al (1996) Allergen avoidance in infancy and allergy at 4 years of age. Allergy 51(2):89–93
Arshad S, Matthews s et al (1992) Effect of allergen avoidance on development of allergic disorders in infancy. Lancet 339(8808): 1493–1497
Du Toit G, Tsakok T et al (2016) Prevention of food allergy. J Allergy Clin Immunol 137(4):998–1010
Du Toit G, Roberts G et al (2015) Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med 372(9):803–813
Togias A, Cooper S (2017) Addendum guidelines for the prevention of peanut allergy in the U.S.: report of the national institute of allergy and infectious diseases sponsored expert panel. J Allergy Clin Immunol 139(1):29–44
Tsai H, Kumar R et al (2009) Familial aggregation of food allergy and sensitization to food allergens: a family-based study. Clin Exp Allergy 39(1):101–109
Gupta R, Walkner M et al (2016) Food allergy sensitization and presentation in siblings of food allergic children. J Allergy Clin Immunol Pract 4(5):956–962
Martino D, Saffery R et al (2016) Epigenetic modifications: mechanisms of disease and biomarkers of food allergy. Curr Opin Immunol 42:9–15
Yazdanbakhsh M, Kremsner P, van Ree R (2002) Allergy, parasites, and the hygiene hypothesis. Science 296(5567):490–494
Du Toit G, Sayre P et al (2016) Effect of avoidance on peanut allergy after early peanut consumption. N Engl J Med 374(15):1435–1443
Lack G (2012) Update on risk factors for food allergy. J Allergy Clin Immunol 129(5):1187–1197
Du Toit G, Roberts G et al (2013) Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study. J Allergy Clin Immunol 131(1):135–143.e1–112
Brough H, Liu A et al (2015) Atopic dermatitis increases the effect of exposure to peanut antigen in dust on peanut sensitization and likely peanut allergy. J Allergy Clin Immunol 135(1):164–170
Lester M (2014) Peanut protein in household dust is related to household peanut consumptions and is biologically active. Pediatrics 134(Suppl 3):S154
Trendelenburg V, Ahrens B, Wehrmann AK, Kalb B, Niggemann B, Beyer K (2013) Peanut allergen in house dust of eating area and 736 bed—a risk factor for peanut sensitization? Allergy 68(11):1460–7371462
Brough H, Makinson A et al (2013) Distribution of peanut protein in the home environment. J Allergy Clin Immunol 132(3):623–629
Johnson R, Barnes C (2013) Airborne concentrations of peanut protein. Allergy Asthma Proc 34(1):59–6
Brough H, Santos A et al (2013) Peanut protein in household dust is related to household peanut consumption and is biologically active. J Allergy Clin Immunol 132(3):630–638
Shroba J, Barnes C, Nanda M, Dinakar C, Ciaccio C (2017) Ara h2 levels in dust from homes of individuals with peanut allergy and individuals with peanut tolerance. Allergy Asthma Proc 38(3):192–196
Brough H, Simpson A et al (2014) Peanut allergy: effect of environmental peanut exposure in children with filaggrin loss-of-function mutations. J Allergy Clin Immunol 134(4):867–875
Trendelenburg V, Tschirner S, Niggemann B, Beyer K (2018) Hen’s egg allergen in house and bed dust is significantly increased after hen’s egg consumption—a pilot study. Allergy 73(1):261–264
Lucendo A, Arias A et al (2014) Relation between eosinophilic esophagitis and oral immunotherapy for food allergy: a systematic review with meta-analysis. Ann Allergy Asthma Immunol 113(6):624–629
Perales CC, Saez Gonzalez E et al (2017) Esophageal dysfunction and immunological changes induced by grass sublingual immunotherapy. Eur Ann Allergy Clin Immunol 49(1):28–30
Hill D, Dudley J et al (2017) The prevalence of eosinophilic esophagitis in pediatric patients with IgE-mediated food allergy. J Allergy Clin Immunol Pract 5(2):369–375
Sicherer S (2001) Clinical implications of cross-reactive food allergens. J Allergy Clin Immunol 108(6):881–889
Oral Allergy Syndrome (2015) http://www.aaaai.org/conditions-and-treatments/library/allergy-library/outdoor-allergies-and-food-allergies-can-be-relate. Accessed 10 Dec 2017
Nowak-Wegrzyn A. (2017) Pathogenesis of oral allergy syndrome (pollen-food allergy syndrome). UpToDate http://www.uptodate.com. Accessed 10 Dec 2017
Bohle B (2007) The impact of pollen-related food allergens on pollen allergy. Allergy 62:3–10
Popescu F (2015) Cross-reactivity between aeroallergens and food allergens. World J Methodol 5(2):31–50
Kondo Y, Urisu A (2009) Oral allergy syndrome. Allergol Int 58:485–491
Werfel T, Asero K, Ballmer-Weber K et al (2015) Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens. Allergy 70:1079–1090
Czarnecka-Operacz M, Jenerowicz D, Silny W (2008) Oral allergy syndrome in patients with airborne pollen allergy treated with specific immunotherapy. Acta Dermatovenerol Croat 16(1):19–24
Lopez-Matas M, Larramendi C et al (2016) In vivo diagnosis with purified tropomyosin in mite and shellfish allergic patients. Ann Allergy Asthma Immunol 116:538–543
Wang J, Calatroni A, Visness C et al (2011) Correlation of specific IgE to shrimp with cockroach and dust mite exposure and sensitization in an inner city population. Allergy Clin Immunol 128(4):834–837
Boquete M, Iraola V, Morales M, Pinto H, Francisco C, Carballás C, Carnés J (2011) Seafood hypersensitivity in mite sensitized individuals: is tropomyosin the only responsible allergen. Ann Allergy Asthma Immunol 106:223–229
Wong L, Huang C, Lee B (2016) Shellfish and house dust allergies: is the link tropomyosin. Allergy Asthma Immunol Res 8(2):101–106
Commins S, Platts-Mills T (2013) Delayed anaphylaxis to red meat in patients with IgE specific for galactose alpha-1, 3-galactose (alpha-gal). Curr Allergy Asthma Rep 13(1):72–77
Platts-Mills T, Schuyler A, Hoyt A et al (2015) Delayed anaphylaxis involving IgE to galactose-alpha-1,3-galactose. Cur Allergy Asthma Rep 15(4):12
Sussman G, Sussman A, Sussman D (2010) Oral allergy syndrome. CMAJ 182(11):1210–1211
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval and Informed Consent
This was a review article and not a study involving human subjects so IRB approval was not required.
Rights and permissions
About this article
Cite this article
Shroba, J., Rath, N. & Barnes, C. Possible Role of Environmental Factors in the Development of Food Allergies. Clinic Rev Allerg Immunol 57, 303–311 (2019). https://doi.org/10.1007/s12016-018-8703-2
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1007/s12016-018-8703-2
