Dendritic Cells: at the Crossroads between Oral Tolerance and Food Allergy

Dendritic cells are specialized antigen presenting cells that bridge innate and adaptive immune responses. Here, we focus on the role of dendritic cells in food tolerance and food allergy pathogenesis and treatment.

In addition to dendritic cells, the recently identified subset of RORγt⁺ antigen presenting cells appears to contribute to oral tolerance to foods. Dendritic cells play a central role in establishing oral food tolerance, but also in aberrantly promoting allergic sensitization when activated by certain inflammatory environmental stimuli. We review what is known about the environmental signals, dendritic cell subsets, and dendritic cell responses that promote both oral food tolerance and allergic sensitization. We also discuss the role of dendritic cells in emerging food allergy treatments such as oral immunotherapy and sublingual immunotherapy. Dendritic cells thus play important and multifaceted roles in tolerance and allergy to foods, and better mechanistic understanding of what distinguishes these processes could lead to improved food allergy prevention and treatment strategies.