Mechanisms of gastrointestinal allergic disorders

J Clin Invest. 2019 Mar 11;129(4):1419-1430. doi: 10.1172/JCI124604.


Gastrointestinal (GI) allergic disease is an umbrella term used to describe a variety of adverse, food antigen-driven, immune-mediated diseases. Although these diseases vary mechanistically, common elements include a breakdown of immunologic tolerance, a biased type 2 immune response, and an impaired mucosal barrier. These pathways are influenced by diverse factors such as diet, infections, exposure to antibiotics and chemicals, GI microbiome composition, and genetic and epigenetic elements. Early childhood has emerged as a critical period when these factors have a dramatic impact on shaping the immune system and therefore triggering or protecting against the onset of GI allergic diseases. In this Review, we will discuss the latest findings on the molecular and cellular mechanisms that govern GI allergic diseases and how these findings have set the stage for emerging preventative and treatment strategies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Epigenesis, Genetic / immunology*
  • Gastrointestinal Diseases* / immunology
  • Gastrointestinal Diseases* / microbiology
  • Gastrointestinal Diseases* / pathology
  • Gastrointestinal Microbiome / immunology*
  • Humans
  • Hypersensitivity* / immunology
  • Hypersensitivity* / microbiology
  • Hypersensitivity* / pathology
  • Intestinal Mucosa* / immunology
  • Intestinal Mucosa* / microbiology
  • Intestinal Mucosa* / pathology
  • Th2 Cells* / immunology
  • Th2 Cells* / pathology