Trends in food protein-induced allergic proctocolitis (FPIAP): Mechanisms and treatment targeting gut microbiome.

Chao Zhang, Yan Liu, Zhenmei Li, Lina Shen, Kejun Shuai, Zhifeng Ning

Journal: Clinics and research in hepatology and gastroenterology 2025;49(7):102634

PMID: 40484124

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE-mediated food allergy characterized by subacute or chronic inflammatory processes in the gut. Unlike IgE-mediated food allergies that may cause multi-organ syndromes, non-IgE-mediated food allergies mainly affect the gastrointestinal tract. The incidence of FPIAP is rising globally, becoming a significant health concern.

OBJECTIVES

This article aims to systematically review the epidemiological characteristics, pathogenesis, cell death programs involved in FPIAP, and its relationship with the gut microbiota. It also explores therapeutic developments targeting the intestinal microbiota.

METHODS

We conducted a comprehensive literature search across multiple databases, including PubMed, Web of Science, and Scopus, up to December 2024. Studies were selected based on predefined inclusion and exclusion criteria. Data extraction and quality assessment were performed by two independent reviewers.

RESULTS

The review identified key epidemiological trends, highlighting the increasing incidence of FPIAP. The pathogenesis section elucidates the mechanisms underlying non-IgE-mediated allergies, emphasizing the role of the gut microbiome in mediating dietary factors and immune responses. Specific cell death programs, such as apoptosis and pyroptosis, were found to be involved in the progression of FPIAP. Therapeutic strategies targeting the gut microbiota show promise in managing FPIAP, with probiotics and prebiotics emerging as potential interventions.

CONCLUSIONS

This review provides valuable insights into the mechanisms of FPIAP and highlights the potential of microbiota-targeted therapies. Future research should focus on large-scale clinical trials to validate the efficacy of these interventions and further explore the complex interplay between diet, gut microbiota, and immune responses in FPIAP.

Address: Department of Internal Medicine, The Second Affiliated Hospital of Hubei University of Science and Technology, Xianning City, Hubei Province 437100, China.; Department of Endocrinology, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning City, Hubei Province 437100, China.; Department of Pediatrics, Xianning Maternal and Child Health Hospital, Xianning City, Hubei Province 437100, China.; Department of Gynaecology and Obstetrics, Zhushan People's Hospital, Zhushan County, Hubei Province, China, 442200.; Department of Pediatrics, Xianning Maternal and Child Health Hospital, Xianning City, Hubei Province 437100, China. Electronic address: [email protected].; Department of Human Anatomy, Basic Medicine College, Hubei University of Science and Technology, Xianning City, Hubei Province 437100, China. Electronic address: [email protected].

DOI: 10.1016/j.clinre.2025.102634

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MeSH Terms: Humans, Dietary Proteins, Food Hypersensitivity, Gastrointestinal Microbiome, Probiotics, Proctocolitis