TY - JOUR
T1 - Summary of the Keystone Symposium “Origins of allergic disease
T2 - Microbial, epithelial and immune interactions,” March 24-27, Tahoe City, California
AU - DeKruyff, Rosemarie H.
AU - Zhang, Wenming
AU - Nadeau, Kari C.
AU - Leung, Donald Y.M.
AU - Wills-Karp, Marsha
N1 - Publisher Copyright:
© 2020 American Academy of Allergy, Asthma & Immunology
PY - 2020/4
Y1 - 2020/4
N2 - The aims of the Keystone Symposium conference, “Origins of allergic disease: Microbial, epithelial and immune interactions” were to present and discuss potential microbial-epithelial-immune interactions underlying the early-life origins of allergic disorders, as well as immune mechanisms that might suggest novel disease prevention or intervention strategies. Cross-talk and sharing of ideas among participating experts in basic science and clinical aspects of allergic diseases provided substantial insight into the concept of allergic disorders as a systems disease. The overriding message distilled from the discussions was that damage to epithelial surfaces lies at the origin of the various manifestations of allergic disease. The epithelium of the lungs, gut, and skin, which operates as a critical sensor of environmental stimuli, is besieged by an onslaught of contemporary environmental forces including an altered microbiome, air pollution, food allergens in a changed diet, and chemicals in modern detergents. Collectively, this onslaught leads to alterations of lung, skin, or gut epithelial surfaces, driving a type 2 immune response that underlies most, if not all, of the atopic diseases. Possible remedies for treatment and prevention of allergic diseases were discussed, including a precision medicine approach using biologics, oral desensitization, targeted gut microbiome alterations, and behavior alteration.
AB - The aims of the Keystone Symposium conference, “Origins of allergic disease: Microbial, epithelial and immune interactions” were to present and discuss potential microbial-epithelial-immune interactions underlying the early-life origins of allergic disorders, as well as immune mechanisms that might suggest novel disease prevention or intervention strategies. Cross-talk and sharing of ideas among participating experts in basic science and clinical aspects of allergic diseases provided substantial insight into the concept of allergic disorders as a systems disease. The overriding message distilled from the discussions was that damage to epithelial surfaces lies at the origin of the various manifestations of allergic disease. The epithelium of the lungs, gut, and skin, which operates as a critical sensor of environmental stimuli, is besieged by an onslaught of contemporary environmental forces including an altered microbiome, air pollution, food allergens in a changed diet, and chemicals in modern detergents. Collectively, this onslaught leads to alterations of lung, skin, or gut epithelial surfaces, driving a type 2 immune response that underlies most, if not all, of the atopic diseases. Possible remedies for treatment and prevention of allergic diseases were discussed, including a precision medicine approach using biologics, oral desensitization, targeted gut microbiome alterations, and behavior alteration.
KW - Atopic dermatitis
KW - asthma
KW - epithelial barrier
KW - food allergy
KW - microbiome
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U2 - 10.1016/j.jaci.2019.11.048
DO - 10.1016/j.jaci.2019.11.048
M3 - Article
C2 - 31926182
AN - SCOPUS:85078861105
SN - 0091-6749
VL - 145
SP - 1072-1081.e1
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 4
ER -