Asia Pac Allergy.  2013 Oct;3(4):257-265. 10.5415/apallergy.2013.3.4.257.

Nuts 'n' guts: transport of food allergens across the intestinal epithelium

• Price D
• Ackland L
• Suphioglu

• KMID: 2397303
• DOI: http://doi.org/10.5415/apallergy.2013.3.4.257

Abstract

The increase in the incidence of food allergy is a growing problem for the western world. This review will focus on the findings from several macromolecular epithelial transport experiments and drug permeability studies to provide a recent comprehension of food allergen intestinal epithelial cell transport and the allergen-epithelial relationship. Specifically, this review will aim to answer whether allergens can permeate the intestinal barrier directly via intestinal epithelial cells, and whether this mode of transport affects downstream immune reactions. By improving our understanding of the interactions which take place during exposure of food allergens with the intestinal epithelium, we can begin to understand whether the epithelial barrier plays a major role in the allergic sensitization process rather than simply restricting the entry of allergens to the underlying lamina propria.

Keyword

Food allergy; Peanut; Intestinal epithelial cell; Cell tight junctions; Cell barrier integrity; Peyer's patch

MeSH Terms

Allergens*
Arachis
Comprehension
Epithelial Cells
Food Hypersensitivity
Incidence
Intestinal Mucosa*
Mucous Membrane
Nuts*
Permeability
Western World
Allergens

Figure

• 

  Fig. 1 Antigen intestinal epithelial transport. Conventional antigen sampling of the intestinal luminal contents occurs via specialized epithelial cells termed M cells. Here, antigens are randomly selected from luminal contents ①. Those antigens which are insoluble and/or have a tendency to aggregate are restricted to crossing the mucosal barrier by this mechanism. Digested peanut allergens aggregate in neutral conditions, and are therefore likely restricted to mucosal passage via M cells only. Therefore, individuals who have a normal digestion capacity (years 2+) are more likely to have peanut allergens absorbed by this mechanism. Despite this, soluble and non-aggregated antigens have the capacity to cross the mucosal barrier through intestinal epithelial cells (IECs). This means that antigens in non-aggregated or more soluble states, such as undigested peanut allergens (peanut ingested by an individual with decreased digestion capacity or a 'leaky gut'; such as an infant) have an additional pathway for those allergens to cross the mucosal barrier and allow exposure to underlying immune cells. IEC passage may either be by parracellular transport ② or transcellular transport ③. Additionally, antigens may be processed and expressed on major histocompatability complex (MHC) II by IEC ④.

• 

  Fig. 2 The transport mechanisms of materials through epithelium. Paracellular transport (a), transcellular transport by diffusion (b), facilitated diffusion (c), transcytosis (d), endocytosis (e), active transport (f), and finally, efflux (g). Paracellular transport, is related to tight junction integrity, while transport mechanisms (b) to (f) are all loosely described as transcellular transport mechanisms. Efflux (g) will not be discussed in this review.

• 

  Fig. 3 Tight junction structure. Transmembrane complexes involving occludin, claudin, and junctional adhesion molecule (JAM) tether the cytoskeleton through intracellular protein complexes. ZO-1, zonula-occludins 1.

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