Ostblom E, Lilja G, Pershagen G, van Hage M, Wickman M
Department of Pediatrics, Sachs' Children's Hospital, Stockholm, Sweden.
Clin Exp Allergy. 2008 Aug;38(8):1325-32. doi: 10.1111/j.1365-2222.2008.03010.x. Epub 2008 May 8.
Longitudinal data from population-based studies on the development and persistence of food hypersensitivity (FHS) during childhood are almost absent.
A population-based birth cohort was established, and information on various exposures and symptoms of allergic disease were obtained from questionnaires when the children were 2 months, 1, 2, 4 and 8 years of age. Complete data were available on 3104 children. Children with reported FHS and doctor's diagnosis of food allergy (RDFA) were identified and allocated into transient, intermittent, late-onset and persistent phenotypes. Food allergen-specific IgE-antibodies (abs) to a mix of six common food allergens (fx5) were analysed at 4 and 8 years of age in 1857 children.
The overall prevalence of reported FHS in combination with RDFA should be 3.1% at 1 year to 7.6% at 8 years of age. However, reactions to milk, egg, fish and wheat decreased, whereas an increase was seen for peanuts and tree nuts. Reported reactions to egg, peanuts or tree nuts early in life, as well as IgE-abs to food allergens at the age of 4, increased the risk of FHS at 8 years of age. Furthermore, FHS at young ages increased the risk for asthma, eczema and allergic rhinitis at 8 years of age, even when adjustments were made for children with these symptoms during the first 2 years of life.
The increasing prevalence of FHS up to the age of 8 years probably reflects an increasing prevalence of allergy to birch pollen and pollen-related reactions to foods. Reactions to egg, peanuts and tree nuts early in life increase the risk of FHS at 8 years. Furthermore, reported FHS at young ages, even though transient, seems to increase the risk for other allergic diseases at 8 years of age.
几乎没有基于人群的关于儿童期食物过敏（FHS）发生和持续情况的纵向数据。
建立了一个基于人群的出生队列，在儿童2个月、1岁、2岁、4岁和8岁时，通过问卷获取各种过敏疾病暴露和症状的信息。获得了3104名儿童的完整数据。确定报告有FHS且经医生诊断为食物过敏（RDFA）的儿童，并将其分为短暂性、间歇性、迟发性和持续性表型。在1857名4岁和8岁儿童中分析了针对六种常见食物过敏原混合物（fx5）的食物过敏原特异性IgE抗体（abs）。
报告的FHS合并RDFA的总体患病率在1岁时为3.1%，在8岁时为7.6%。然而，对牛奶、鸡蛋、鱼类和小麦的反应减少，而对花生和坚果的反应增加。早年报告的对鸡蛋、花生或坚果的反应，以及4岁时对食物过敏原的IgE-abs，增加了8岁时患FHS的风险。此外，即使对生命最初2年内有这些症状的儿童进行了调整，早年的FHS仍增加了8岁时患哮喘、湿疹和过敏性鼻炎的风险。
8岁前FHS患病率的增加可能反映了对桦树花粉过敏和与花粉相关的食物反应患病率的增加。早年对鸡蛋、花生和坚果的反应增加了8岁时患FHS的风险。此外，早年报告的FHS，即使是短暂性的，似乎也增加了8岁时患其他过敏性疾病的风险。
