Marzo 2009 - Volume XXVIII - numero 3
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
1Professore Emerito, Dipartimento di Scienze della Riproduzione e dello Sviluppo, Università di Trieste
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Key words: Diet, IgE, Atopy, Asthma, Eczema, Anaphylaxis
In the last few years, sufficient evidences have been collected to consider the delayed administration of heterologus and allergogenous food, in the hope of avoiding the IgE sensitization, useless and probably counterproductive. Actually, the passage of food through the oro-gastric-intestinal tract is indispensable for the production of the immunological tolerance with the activation, through GALT, of the Th1 system. In fact, the peanut allergy is common in those countries where peanuts are not consumed during the first few months or years of life, whereas it is rare where their consumption is abundant since infancy. Asthma, eczema and anaphylaxis are typical manifestations of the IgE -mediated atopy. Actually, both asthma and eczema are IgE-mediated only in some cases and in all cases they need specific organ sensitivity; only anaphylaxis is always IgE-mediated and has not a specific target organ. Atopic dermatitis represents another paradoxical condition: it is not the result of sensitization; it occurs consequentially and transcutaneously and is facilitated by any food avoidance that short-circuits the intestinal tolerogenous system. Observational and experimental data suggest that the best age to obtain the immunological tolerance is the forth-fifth month of life.
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