The genetics of food allergy

The role of the gut mucosal immunity in the development of tolerance against allergy to food

PURPOSE OF REVIEW

To provide an overview on the role of gut mucosal immunity in the development of tolerance against allergy to food.

RECENT FINDINGS

The gastrointestinal tract, through innate and specific immunologic factors, acts as a defense against ingested antigens. In addition to the mucous membrane integrity and digestion, numerous specific immunologic cells and mediators orchestrate such defensive mechanisms. In case of food antigens, the outcome is usually in favor of tolerance. Defects in that barrier, however, can lead to the development of aberrant immunologic responses, including hypersensitivity reactions.

SUMMARY

The prevailing evidence is that healthy mucosal immunity plus appropriate feeding regimen during early infancy are in favor of food tolerance. However, in addition to genetic predisposition, development of allergy is facilitated by defects in the gut barrier (immune or nonimmune) and the food allergen load.

Lack of association of HLA class II alleles with peanut allergy

BACKGROUND

Peanut allergy is a common and severe phenotype of food allergy with a strong genetic component; HLA class II polymorphisms are attractive candidate genes for this disorder.

OBJECTIVE

To determine possible genotypic associations of HLA class II with peanut allergy and attempt replication of previously reported associations.

METHODS

Sibling pairs discordant for peanut allergy were genotyped (low resolution) by polymerase chain reaction-based methods to 7 DQ and 18 DR allele groups. A chi2 analysis was undertaken against sibling controls with statistical adjustment for multiple analyses.

RESULTS

Seventy-three children with confirmed peanut allergy (mean age, 6.5 years; male, 72%; asthma, 58%; atopic dermatitis, 62%; allergic rhinitis, 67%; other food allergies, 41%) and 75 of their siblings who eat peanut (mean age, 8 years; male, 52%; asthma, 12%; atopic dermatitis, 22%; allergic rhinitis, 37%; other food allergy, 7%) were genotyped. Distribution of DQ7 (29% of children with peanut allergy vs 47% sibling controls) was statistically significantly different (P = .04) before statistical correction for multiple comparisons was made by multiplying them by the number of alleles tested (and not statistically significant after correction; P = .30). Distribution of DR11 was nearly statistically significant without statistical adjustment (26% with peanut allergy vs 41% of sibling controls; P = .07; corrected P = 1.3). Alleles that were previously reported to have a weak association with peanut allergy (DRB1 *03, *08; DQB1 *0302, *04) were not verified in this cohort (unadjusted P > .44).

CONCLUSIONS

We could not establish an association between the HLA class II alleles evaluated in this cohort of sibling pairs discordant for peanut allergy.