Sialic acid and food allergies: The link between nutrition and immunology

Crit Rev Food Sci Nutr. 2024;64(12):3880-3906. doi: 10.1080/10408398.2022.2136620. Epub 2022 Nov 12.

Abstract

Food allergies (FA), a major public health problem recognized by the World Health Organization, affect an estimated 3%-10% of adults and 8% of children worldwide. However, effective treatments for FA are still lacking. Recent advances in glycoimmunology have demonstrated the great potential of sialic acids (SAs) in the treatment of FA. SAs are a group of nine-carbon α-ketoacids usually linked to glycoproteins and glycolipids as terminal glycans. They play an essential role in modulating immune responses and may be an effective target for FA intervention. As exogenous food components, sialylated polysaccharides have anti-FA effects. In contrast, as endogenous components, SAs on immunoglobulin E and immune cell surfaces contribute to the pathogenesis of FA. Given the lack of comprehensive information on the effects of SAs on FA, we reviewed the roles of endogenous and exogenous SAs in the pathogenesis and treatment of FA. In addition, we considered the structure-function relationship of SAs to provide a theoretical basis for the development of SA-based FA treatments.

Keywords: Allergic diseases; N-acetylneuraminic acid; allergen-specific immunotherapy; human milk oligosaccharides; sialic acid-binding immunoglobulin-type lectins.