{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:17:43Z","timestamp":1792887463780,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Council","award":["MR\/M008517\/1"],"award-info":[{"award-number":["MR\/M008517\/1"]}]},{"name":"Medical Research Council","award":["MC\/PC\/18052"],"award-info":[{"award-number":["MC\/PC\/18052"]}]},{"name":"Medical Research Council","award":["MR\/T032081\/1"],"award-info":[{"award-number":["MR\/T032081\/1"]}]},{"name":"Medical Research Council","award":["AUK-BC-2015-01"],"award-info":[{"award-number":["AUK-BC-2015-01"]}]},{"name":"NIH, Asthma UK","award":["MR\/M008517\/1"],"award-info":[{"award-number":["MR\/M008517\/1"]}]},{"name":"NIH, Asthma UK","award":["MC\/PC\/18052"],"award-info":[{"award-number":["MC\/PC\/18052"]}]},{"name":"NIH, Asthma UK","award":["MR\/T032081\/1"],"award-info":[{"award-number":["MR\/T032081\/1"]}]},{"name":"NIH, Asthma UK","award":["AUK-BC-2015-01"],"award-info":[{"award-number":["AUK-BC-2015-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Foods"],"abstract":"<jats:p>Oral tolerance is the active absence of response to food allergens, which involves complex mechanisms in the gut-associated lymphoid tissue. Food allergy results from the disruption of such tolerance or the absence of its establishment in the first place. It follows allergic sensitization with the production of allergen-specific IgE and results from the degranulation of basophils and mast cells on subsequent exposure to the allergen. Oral tolerance induction has been explored in the contexts of prevention and treatment of food allergy. Early introduction of allergenic foods (i.e., egg and peanut) in the diet of infants, before allergic sensitization occurs (i.e., via inflamed skin affected with eczema) has shown to be beneficial. Guidelines have changed to recommend the introduction of these allergenic foods by 6 months of age. For food allergic individuals, oral tolerance induction has been attempted using allergen-specific immunotherapy, which involves the administration of an allergen, modified or not, through various possible routes, including oral, sublingual, epicutaneous, and subcutaneous, with or without concomitant administration of antibody-based biologics. Further research into the immune mechanisms of food allergy and oral tolerance can lead to the identification of novel targets to suppress the food allergic response and reverse the current food allergy epidemic.<\/jats:p>","DOI":"10.3390\/foods11213386","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T20:37:58Z","timestamp":1666903078000},"page":"3386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Oral Tolerance Induction\u2014Opportunities and Mechanisms"],"prefix":"10.3390","volume":"11","author":[{"given":"Ru-Xin","family":"Foong","sequence":"first","affiliation":[{"name":"Department of Women and Children\u2019s Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 9RT, UK"},{"name":"Children\u2019s Allergy Service, Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust, London SE1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7805-1436","authenticated-orcid":false,"given":"Alexandra F.","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 9RT, UK"},{"name":"Children\u2019s Allergy Service, Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust, London SE1 7EH, UK"},{"name":"Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King\u2019s College London, London SE1 9RT, UK"},{"name":"Asthma UK Centre for Allergic Mechanisms of Asthma, London E1 8AA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2332\/allergolint.13-RAI-0603","article-title":"Epicutaneous Immunity and Onset of Allergic Diseases-Per-\u201cEczema\u201dtous Sensitization Drives the Allergy March","volume":"62","author":"Matsumoto","year":"2013","journal-title":"Allergol. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1159\/000487380","article-title":"Food Allergy Prevention and Treatment by Targeted Nutrition","volume":"72","author":"Heine","year":"2018","journal-title":"Ann. Nutr. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.alit.2016.08.001","article-title":"Prevention of food allergy\u2014Early dietary interventions","volume":"65","author":"Foong","year":"2016","journal-title":"Allergol. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.jaci.2014.08.011","article-title":"Peanut allergy: Effect of environmental peanut exposure in children with filaggrin loss-of-function mutations","volume":"134","author":"Brough","year":"2014","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1016\/j.jaci.2014.07.033","article-title":"Filaggrin loss-of-function mutations are associated with food allergy in childhood and adolescence","volume":"134","author":"Venkataraman","year":"2014","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/j.0105-2896.2005.00280.x","article-title":"Oral tolerance","volume":"206","author":"Faria","year":"2005","journal-title":"Immunol Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.jaci.2010.12.1116","article-title":"Mechanisms of immune tolerance relevant to food allergy","volume":"127","author":"Vickery","year":"2011","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.jaci.2016.02.004","article-title":"Molecular and cellular mechanisms of food allergy and food tolerance","volume":"137","author":"Chinthrajah","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.iac.2017.09.003","article-title":"Oral Tolerance Development and Maintenance","volume":"38","author":"Wambre","year":"2017","journal-title":"Immunol. Allergy Clin. North Am."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"568598","DOI":"10.3389\/fimmu.2020.568598","article-title":"Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy","volume":"11","author":"Schoos","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s12016-018-8710-3","article-title":"IgE-Mediated Food Allergy","volume":"57","author":"Anvari","year":"2019","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"eaaw6433","DOI":"10.1126\/science.aaw6433","article-title":"Identification of a T follicular helper cell subset that drives anaphylactic IgE","volume":"365","author":"Gowthaman","year":"2019","journal-title":"Science"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.jaci.2021.02.029","article-title":"Peanut diversity and specific activity are the dominant IgE characteristics for effector cell activation in children","volume":"148","author":"Hemmings","year":"2021","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1126\/science.aau2599","article-title":"High-affinity allergen-specific human antibodies cloned from single IgE B cell transcriptomes","volume":"362","author":"Croote","year":"2018","journal-title":"Science"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"De Martinis, M., Sirufo, M.M., Suppa, M., and Ginaldi, L. (2020). New Perspectives in Food Allergy. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21041474"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s12016-018-8678-z","article-title":"The Use of Biomarkers to Predict Aero-Allergen and Food Immunotherapy Responses","volume":"55","author":"Sindher","year":"2018","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.jaci.2008.08.039","article-title":"Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy","volume":"122","author":"Katz","year":"2008","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1056\/NEJMoa1414850","article-title":"Randomized trial of peanut consumption in infants at risk for peanut allergy","volume":"372","author":"Roberts","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1056\/NEJMoa1514210","article-title":"Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants","volume":"374","author":"Perkin","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.jaci.2013.01.017","article-title":"Vitamin D insufficiency is associated with challenge-proven food allergy in infants","volume":"131","author":"Allen","year":"2013","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/S0140-6736(16)31418-0","article-title":"Two-step egg introduction for prevention of egg allergy in high-risk infants with eczema (PETIT): A randomised, double-blind, placebo-controlled trial","volume":"389","author":"Natsume","year":"2016","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3389\/fped.2016.00034","article-title":"Asthma and Food Allergy in Children: Is There a Connection or Interaction?","volume":"4","author":"Caffarelli","year":"2016","journal-title":"Front. Pediatr."},{"key":"ref_23","first-page":"e1","article-title":"Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-Sponsored Expert Panel","volume":"34","author":"Togias","year":"2017","journal-title":"Pediatr. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1111\/pai.13496","article-title":"EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update)","volume":"32","author":"Halken","year":"2021","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.jaci.2019.07.032","article-title":"Earlier ingestion of peanut after changes to infant feeding guidelines: The EarlyNuts study","volume":"144","author":"Soriano","year":"2019","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/S0140-6736(00)67313-0","article-title":"A Case of Egg Poisoning","volume":"171","author":"Schofield","year":"1908","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2848","DOI":"10.1080\/21645515.2018.1502126","article-title":"New modalities of allergen immunotherapy","volume":"14","author":"Ramesh","year":"2018","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_28","first-page":"1991","article-title":"Faculty Opinions recommendation of AR101 oral immunotherapy for peanut allergy","volume":"379","author":"Hogan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1016\/S0140-6736(19)31793-3","article-title":"Sustained outcomes in oral immunotherapy for peanut allergy (POISED study): A large, randomised, double-blind, placebo-controlled, phase 2 study","volume":"394","author":"Chinthrajah","year":"2019","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1111\/all.13138","article-title":"Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma: An EAACI Position Paper","volume":"72","author":"Shamji","year":"2017","journal-title":"Allergy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1001\/jama.2019.1113","article-title":"Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial","volume":"321","author":"Fleischer","year":"2019","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.jaci.2020.06.028","article-title":"Long-term, open-label extension study of the efficacy and safety of epicutaneous immunotherapy for peanut allergy in children: PEOPLE 3-year results","volume":"146","author":"Fleischer","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/j.jaci.2019.12.007","article-title":"Vaccine against peanut allergy based on engineered virus-like particles displaying single major peanut allergens","volume":"145","author":"Storni","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/j.imbio.2012.10.008","article-title":"Passive immunization with allergen-specific IgG antibodies for treatment and prevention of allergy","volume":"218","author":"Flicker","year":"2013","journal-title":"Immunobiology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jaci.2021.05.039","article-title":"Novel antibody cocktail targeting Bet v 1 rapidly and sustainably treats birch allergy symptoms in a phase 1 study","volume":"149","author":"Gevaert","year":"2022","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/cea.13084","article-title":"The use of omalizumab in allergen immunotherapy","volume":"48","author":"Dantzer","year":"2018","journal-title":"Clin. Exp. Allergy"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e131347","DOI":"10.1172\/jci.insight.131347","article-title":"Phase 2a randomized, placebo-controlled study of anti-IL-33 in peanut allergy","volume":"4","author":"Chinthrajah","year":"2019","journal-title":"JCI Insight"}],"container-title":["Foods"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-8158\/11\/21\/3386\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:04:03Z","timestamp":1760144643000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-8158\/11\/21\/3386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,27]]},"references-count":37,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["foods11213386"],"URL":"https:\/\/doi.org\/10.3390\/foods11213386","relation":{},"ISSN":["2304-8158"],"issn-type":[{"value":"2304-8158","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,27]]}}}