Abstract
The mucosal immune system has bidirectional tasks to mount an effective defense against invading harmful pathogens and to suppress the immune response to alimentary antigens and commensal bacterial flora. Oral tolerance is a suppression of the mucosal immune pathway related to a specific immunophenotype of the dendritic cells and an induction of the regulatory T cells as well as with the silencing of the effector T cell response by anergy and deletion. The physiological dynamic process of the anatomical and functional maturation of the immune system occurring in children during pre- and postnatal periods is a significant factor, having an impact on the fine balance between the activation and the suppression of the immune response. In this paper, mechanisms of mucosal immunity and tolerance induction in terms of maturational issues are discussed with a special emphasis on the implications for a novel therapeutic intervention in allergic diseases via the sublingual route.
Highlights
The mucosal immune system comprises the lymphoidassociated structures of the nasal, bronchial, gastrointestinal, and genitourinary tracts as well as lacrimal, salivary, and lactating mammary glands and the synovium of joints
It is composed of a dynamic network of highly specialized components of the innate and adaptive immune responses, which give rise to the functional common mucosal immune system (CMIS) and ensure fine, organ-specific balance between activation and suppression
During this age, an imperfect regulatory immune response, which is of crucial importance in developing oral mucosal immunity, may pose an increased risk of food allergies
Summary
The mucosal immune system comprises the lymphoidassociated structures of the nasal, bronchial, gastrointestinal, and genitourinary tracts as well as lacrimal, salivary, and lactating mammary glands and the synovium of joints It is composed of a dynamic network of highly specialized components of the innate and adaptive immune responses, which give rise to the functional common mucosal immune system (CMIS) and ensure fine, organ-specific balance between activation and suppression. The fundamental challenge of mucosal immune response is to prevent effectively the entry of invading pathogens and the development and the disseminating of infection, whereas simultaneously its exposition to the external environment and to a high antigenic load elicits immune tolerance These interrelated processes of active promotion and suppression of immunity provide a defense against microorganisms and neoplasms and protect against inflammatory pathologies such as allergy and autoimmunity as well. If developing new strategies of immunotherapy which exploit the establishing of an oral mucosal tolerance has a rationale in pediatric patients is here the subject of discussion
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