The development of oral tolerance is an antigen-driven process that appears to depend on regular exposure to foods and other antigens during critical early stages of development. Successful tolerance is also likely to depend on other conducive exposures (such as favourable gut colonisation, breast milk and/or other immunomodulatory factors). It is now increasingly evident that allergen exposure is not the primary cause of the allergy epidemic, and that allergen avoidance may be unsuccessful, or even detrimental in allergy prevention. Indeed, rising rates of immune disease are likely to reflect a combination of many environmental changes which compromise tolerance. Understanding other early host-environment interactions is essential to designing better strategies to prevent disease. This review explores the evidence for early defects in immune pathways that may be important for promoting tolerance, and the effects of environmental exposures on these pathways.
|Journal||Current Allergy & Clinical Immunology|
|Publication status||Published - 2008|