IgE-mediated food allergy is estimated to affect approximately 8% of children in the United States. The rapid rise of food allergy beginning in the 1990s suggest important regulation of food allergy by environmental factors. The healthy gastrointestinal immune system responds to innocuous food antigens with an active regulatory response called oral tolerance, characterized by antigen-specific Tregs and IgA and IgG antibodies. In food allergic individuals the immune response is deviated to a Th2-biased immune response and generation of allergen-specific IgE antibodies that trigger acute reactions to foods. In this chapter, the immune mechanisms responsible for the deviation from oral tolerance are discussed, including the role of the microbiota and evidence for communication between the skin and the gastrointestinal tract in food allergy.

Original languageEnglish
Title of host publicationEncyclopedia of Gastroenterology, Second Edition
Number of pages7
ISBN (Electronic)9780128124604
StatePublished - 1 Jan 2019


  • Anaphylaxis
  • Epicutaneous immunotherapy
  • Food allergy
  • IgE
  • Microbiota
  • Oral immunotherapy
  • Th2
  • Tolerance
  • Tregs


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