Abstract

Food allergies and other immune-mediated diseases have become serious health concerns amongst infants and children in developed and developing countries. The absence of available cures limits disease management to allergen avoidance and symptomatic treatments. Research has suggested that the presence of maternal food allergies may expose the offspring to genetic predisposition, making them more susceptible to allergen sensitization. The following review has focused on epidemiologic studies regarding maternal influences of proneness to develop food allergy in offspring. The search strategy was “food allergy OR maternal effects OR offspring OR prevention”. A systematically search from PubMed/MEDLINE, Science Direct and Google Scholar was conducted. Specifically, it discussed the effects of maternal immunity, microbiota, breastfeeding, genotype and allergy exposure on the development of food allergy in offspring. In addition, several commonly utilized prenatal and postpartum strategies to reduce food allergy proneness were presented, including early diagnosis of high-risk infants and various dietary interventions.

Highlights

  • Research estimates that the food allergy currently affects 5–8% of the United States population, and the prevalence of food allergy in young children could grow as rapidly as 1% in a decade [8], while that of preschool children in developed and developing countries were as high as 10% (Australia) and 7% (China), respectively [2]

  • Throughout the years, accumulating evidence from epidemiological, in vivo, and in vitro experimentation has shed light on the possibility that infants with an atopic family history are genetically predisposed to allergies, especially those born from actively atopic mothers [9, 10]. 12% of children with no family history of allergy, 30% to 50% of children with a single parental allergy and 60% to 80% of children with biparental allergies will develop allergic disease [11]

  • Despite the lack of a complete understanding regarding the role of maternal allergen transfer in the development of offspring allergenicity, the most commonly postulated theory is that allergens can be transferred from the mother to fetus in the form of an immunoglobulin G (IgG)/allergen immune complex [28]

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Summary

INTRODUCTION

The term “allergy” describes an adverse immune response initiated by the host’s immune system upon exposure to a given substance that is generally harmless in the environment. Over the past several decades, food allergy has emerged unexpectedly as a “second wave” of the allergy epidemic, with an increasing number of infants and children afflicted with the disease from developing and developed countries worldwide [4–6]. Research estimates that the food allergy currently affects 5–8% of the United States population, and the prevalence of food allergy in young children could grow as rapidly as 1% in a decade [8], while that of preschool children in developed and developing countries were as high as 10% (Australia) and 7% (China), respectively (proven by the oral food challenge test) [2]. A thorough understanding of the underlying mechanisms that mediate maternal influence to develop food allergy in children is critical to developing prevention and treatment strategies for allergic reactions and similar inflammatory diseases (Figure 1)

FOOD ALLERGY
INFLUENCE OF MATERNAL IMMUNITY
INFANT IMMUNITY
ROLE OF BREASTFEEDING
ALLERGEN EXPOSURE DURING PREGNANCY AND LACTATION
INFLUENCE OF MATERNAL GENOTYPE
MATERNAL MICROBIOTA
PREVENTION AND MANAGEMENT
Immunotherapy Hydrolysate Formula
PROBIOTIC INTERVENTION
IMMUNOTHERAPY INTERVENTION
HYDROLYSATE FORMULA INTERVENTION
Findings
SUMMARY
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