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Role of Regulatory T-cells in Oral Tolerance and Immunotherapy

Mark Farrugia and Byron Baron

Food allergies encompass a range of disorders ranging from being an inconvenience to even causing fatalities, mainly due to anaphylaxis. A large number of individuals are affected and this presents great health and economic implications. However as yet, apart from dietary avoidance, effective treatment strategies are practically non-existent. The immune environment related to allergen-tolerance is highly complex and the role of regulatory T-cells in allergenspecific tolerance, their interaction with other cells in inflamed tissues, and their role in antibody regulation have been demonstrated in several studies. Regulatory T-cells are able to control acquired immunity and achieve oral tolerance to food allergens. Immunotherapy for food allergies focuses on desensitisation by increasing the allergen reactivity threshold. So far, the only long-term curative treatment used effectively is allergen-specific immunotherapy which involves the administration of increasing doses of the causative allergen, such that a state of allergen-specific immune tolerance is induced over the course of the treatment. This review covers various forms of allergen-specific immunotherapy, focusing on the role of regulatory T-cells in such therapies, and includes a number of small studies providing ideas for future work in the area.