Palmer Kricia, Burks Wesley
Duke University Medical Center, Pediatric Allergy and Immunology, Durham, New Carolina 27710, USA.
Curr Opin Allergy Clin Immunol. 2006 Jun;6(3):202-6. doi: 10.1097/01.all.0000225161.60274.31.
Peanut allergy is among the most serious, life-threatening food sensitivities, and recent studies indicate increasing prevalence, particularly among children. Our objective is to highlight recent advances in the immunology and treatment of peanut allergy.
Peanut sensitization may be both a Th1- and Th2-driven process, and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) may play a role in regulating the response intensity. Preliminary work shows that the food matrix is important in the immune response to peanut and that purified peanut allergens may have little intrinsic stimulatory capacity. Studies characterizing peanut allergens have revealed Ara h 1 and Ara h 2 as the most potent allergens, but Ara h 3 may be more allergenic than previously thought. There appears to be a relationship between the diversity of IgE-binding patterns and the severity of clinical symptoms. Multiple novel approaches to treatment are being investigated, which include traditional Chinese medicine, various forms of modified immunotherapy and the use of adjuvants in modified immunotherapy.
By understanding the immunologic response to peanut and the roles of the major peanut allergens, it may be possible to predict those at risk for severe reactions, prevent peanut sensitization and effectively treat those already sensitized.
花生过敏是最严重的、危及生命的食物过敏之一，近期研究表明其患病率呈上升趋势，尤其是在儿童中。我们的目的是强调花生过敏在免疫学和治疗方面的最新进展。
花生致敏可能是由Th1和Th2驱动的过程，细胞毒性T淋巴细胞相关抗原4（CTLA-4）可能在调节反应强度中发挥作用。初步研究表明，食物基质在花生免疫反应中很重要，纯化的花生过敏原可能几乎没有内在刺激能力。对花生过敏原的研究表明，Ara h 1和Ara h 2是最具活性的过敏原，但Ara h 3的致敏性可能比之前认为的更强。IgE结合模式的多样性与临床症状的严重程度之间似乎存在关联。正在研究多种新型治疗方法，包括中药、各种形式的改良免疫疗法以及在改良免疫疗法中使用佐剂。
通过了解对花生的免疫反应以及主要花生过敏原的作用，有可能预测那些有严重反应风险的人，预防花生致敏，并有效治疗那些已经致敏的人。
