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Venter C, Meyer RW, Nwaru BI, Roduit C, Untersmayr E, Adel‐Patient K, Agache I, Agostoni C, Akdis CA, Bischoff S, du Toit G, Feeney M, Frei R, Garn H, Greenhawt M, Hoffmann‐Sommergruber K, Lunjani N, Maslin K, Mills C, Muraro A, Pali I, Poulson L, Reese I, Renz H, Roberts GC, Smith P, Smolinska S, Sokolowska M, Stanton C, Vlieg‐Boerstra B, O'Mahony L. EAACI position paper: Influence of dietary fatty acids on asthma, food allergy, and atopic dermatitis. Allergy 2019; 74:1429-1444. [PMID: 31032983 DOI: 10.1111/all.13764] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/12/2019] [Accepted: 02/21/2019] [Indexed: 12/11/2022]
Abstract
The prevalence of allergic diseases such as allergic rhinitis, asthma, food allergy, and atopic dermatitis has increased dramatically during the last decades, which is associated with altered environmental exposures and lifestyle practices. The purpose of this review was to highlight the potential role for dietary fatty acids, in the prevention and management of these disorders. In addition to their nutritive value, fatty acids have important immunoregulatory effects. Fatty acid-associated biological mechanisms, human epidemiology, and intervention studies are summarized in this review. The influence of genetics and the microbiome on fatty acid metabolism is also discussed. Despite critical gaps in our current knowledge, it is increasingly apparent that dietary intake of fatty acids may influence the development of inflammatory and tolerogenic immune responses. However, the lack of standardized formats (ie, food versus supplement) and standardized doses, and frequently a lack of prestudy serum fatty acid level assessments in clinical studies significantly limit our ability to compare allergy outcomes across studies and to provide clear recommendations at this time. Future studies must address these limitations and individualized medical approaches should consider the inclusion of specific dietary factors for the prevention and management of asthma, food allergy, and atopic dermatitis.
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Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology University of Colorado Denver School of Medicine, Children's Hospital Colorado Colorado
| | | | - Bright I. Nwaru
- Krefting Research Centre, Institute of Medicine University of Gothenburg Gothenburg Sweden
| | - Caroline Roduit
- University Children's Hospital Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Eva Untersmayr
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Karine Adel‐Patient
- Service de Pharmacologie et d'Immunoanalyse, Laboratoire d'Immuno‐Allergie Alimentaire (LIAA) INRA, CEA, Université Paris Saclay Gif sur Yvette Cedex France
| | | | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda ‐ Ospedale Maggiore Policlinico Milano Italy
- Dipartimento di Scienze Cliniche e di Comunita Universita' degli Studi Milano Italy
| | - Cezmi A. Akdis
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Stephan Bischoff
- Institut für Ernährungsmedizin Universität Hohenheim Stuttgart Germany
| | - George du Toit
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Mary Feeney
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Holger Garn
- Center for Tumor‐ and Immunobiology (ZTI), Institute of Laboratory Medicine and Pathobiochemistry Philipps University of Marburg ‐ Medical Faculty Marburg Germany
| | - Matthew Greenhawt
- School of Medicine, Section of Allergy and Immunology Children's Hospital Colorado, University of Colorado Aurora Colorado
| | - Karin Hoffmann‐Sommergruber
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- University of Cape Town Cape Town South Africa
| | - Kate Maslin
- MRC Lifecourse Epidemiology Unit University of Southampton Southampton UK
| | - Clare Mills
- School of Biological Sciences, Manchester Academic Health Sciences Centre, Manchester Institute of Biotechnology The University of Manchester Manchester UK
| | - Antonella Muraro
- Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera Università di Padova Padova Italy
| | - Isabella Pali
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna Medical University Vienna Vienna Austria
| | - Lars Poulson
- Allergy Clinic, Dept. of Skin and Allergy Diseases Copenhagen University Hospital at Gentofte Copenhagen Denmark
| | - Imke Reese
- Dietary Counseling and Nutrition Therapy Centre Munich Germany
| | - Harald Renz
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL) Philipps Universität Marburg Marburg Germany
| | - Graham C. Roberts
- The David Hide Asthma and Allergy Research Centre St Mary's Hospital Newport UK
- NIHR Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health Academic Units University of Southampton Southampton UK
| | - Peter Smith
- School of Medicine Griffith University Southport Australia
| | - Sylwia Smolinska
- Department of Clinical Immunology Wroclaw Medical University Wroclaw Poland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | | | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Depts of Medicine and Microbiology APC Microbiome Ireland, National University of Ireland Cork Ireland
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