Figure 1: Pathophysiology of IgE-mediated food allergy
The interplay between the environment and barrier dysfunction drives Th2-type allergic responses. Epithelial cells in the skin and gastrointestinal tract are actively involved in immune responses by producing and secreting cytokines. Alarmins or damage-associated molecular patterns (DAMPs) including IL-33, IL-25, TSLP and PGE2 are epithelial cell-derived cytokines that are central regulators of allergic responses. In addition to the classical effector cells (mast cells, basophils, eosinophils, ILC2 cells, B cells and Th2 cells), other T cell subsets are proposed players in IgE-mediated allergy including: Tfh13, Th22, Th9, Th17, and Tfh2 cells. Immunosuppressive cell subsets including T regulatory cells and the recently described ILCregs also play a role by regulating responses.