This study investigates the processes by which commensal bacteria control tolerance to dietary allergens and discuss the evidence that environmental stressors that disrupt naturally selected host-microbe interactions are driving the rising prevalence of food allergy. Antibiotic usage and a high-fat/low-fiber diet have a significant and fast influence on gut bacterial populations, with long-term implications for both overall microbial community structure and host immune control. Recent research highlights the importance of mucosa-associated commensal bacteria in triggering a barrier-protective response that is essential for avoiding allergy sensitization to food. Murine model studies are guiding the development of innovative live biotherapeutic methods as an additional therapy to improve antigen-specific oral desensitization and achieve long-term tolerance in food allergy patients.

Food allergy therapy strategies focused on altering the makeup and/or functionality of the gut microbiota show promise.