Mucosal Immunity: from Allergy to Coeliac Disease

  • Per Brandtzaeg
Part of the Allergy Frontiers book series (ALLERGY, volume 2)

During evolution, the mucosal immune system has developed two homeostatic mechanisms: (i) immune exclusion mediated by secretory antibodies to control epithelial colonization of microorganisms and inhibit penetration of potentially dangerous substances; and (ii) immunosuppression to counteract hypersensitivity against innocuous antigens such as allergens and most food proteins. The latter mechanism is referred to as ‘oral tolerance’ when induced via the gut. Similar down-regulatory mechanisms apparently operate against components of the commensal microbiota. This two-layered anti-inflammatory preservation of mucosal integrity probably explains why overt and persistent allergy to dietary proteins is not more common, with the exception of gluten-intolerance (coeliac disease), where abrogation of mucosal homeostasis becomes apparent.

Overall, mucosally induced oral tolerance is a robust adaptive mechanism in view of the fact that a ton of food may pass annually through the gut of an adult ? regularly resulting in uptake of some intact dietary antigens. However, the immunoregulatory network and the epithelial barrier function are poorly developed for a variable period after birth. The neonatal period is therefore critical with regard to priming for allergy. Notably, the postnatal development of mucosal immune homeostasis depends on appropriate microbial colonization. In this process, dendritic antigen-presenting cells are ‘decision makers’ ? linking innate and adaptive immunity; their function is influenced by both microbial products and dietary constituents, including vitamin A and lipids such as polyunsaturated -3 fatty acids.


Celiac Disease Treg Cell Food Allergy Lamina Propria Allergy Clin Immunol 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Per Brandtzaeg
    • 1
  1. 1.Laboratory for Immunohistochemistry and Immunopathology (LIIPAT), Institute and Division of PathologyUniversity of Oslo, Rikshospitalet University HospitalOslo

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