Commensal collaborations: Food allergy and the microbiome

The rising prevalence of food allergy over recent decades has motivated interest in broader factors that may influence suscep-tibility and disease course, including the microbiome. With microbiota representing 70% to 90% of cells and 99% of genes in and on human bodies, it is compelling to consider that the microbiome plays a role in food allergy and our overall biology. Environmental and epidemiologic factors that influence microbial exposures have been linked to food allergy risk, including protective effects from a high-fiber diet and exposure during infancy to farm animals and pets, older siblings, vaginal birth, and breast-feeding (Fig 1). More directly, the findings of distinct gut microbiome features in individuals with food allergy, the presence of dysbiosis preceding food allergy, and murine models demonstrating the potential to transfer food allergy phenotypes via fecal transfer have also been reported and provide intriguing data to motivate ongoing investigations of microbial manipulation for potential prevention and treatment of food allergy. Here, we discuss current understandings and our perspective on evolving research directions in the microbiome and food allergy.