The gut microbiome-immune axis as a target for nutrition-mediated modulation of food allergy

Abstract Background Food allergy (FA) is a serious food safety and public health issue. Increasing evidence has shed new light on significant interference of gut microbiome with mechanisms involved in the pathophysiology and progression of FA. New insights into the crosstalk between food components and the gut microbiome enable the development of viable strategies for inducing oral tolerance and modulating immune homeostasis. Scope and approach In this review, we first provide a brief outline of the observational evidence that supports associations between microbial exposures and FA, followed by an elaborated description of causation and the mechanisms by which the gut microbiome regulates FA. Subsequently, we highlight in detail how specific food components, pre- and probiotics can modulate the gut microbiome-immune axis and, consequently, modify the development of FA. Key Findings and Conclusions The gut microbiome is a critical factor affecting FA susceptibility, and its regulatory mechanism is primarily through increasing protective Tregs and enhancing the intestinal mucosal barrier. The intake of high-fiber, tryptophan-rich diet and supplementation of diet with n-3PUFAs, polyphenols, pre- and probiotics, which are known to modulate gut microbiota towards to beneficial outcomes, while avoiding high-fat foods that trigger dysbiosis, can not only provide a potential approach to reduce the risk of FA in a primary prevention setting, but may also be a promising therapeutic strategy. This paper will contribute to dovetail food intervention strategies and bacterial therapeutics to modulate the immune system of allergic individuals in such a way that FA can be prevented and FA symptoms mitigated.