Clínica de Asma y Alergia Dres. Ojeda, Madrid, Spain.
J Investig Allergol Clin Immunol. 2010;20(6):524-8.
In Spain, peanut allergy is increasingly prevalent. Successful protocols for the induction of oral tolerance (LOT) with several foods have been reported. We aimed to induce clinical tolerance to peanut in a child with severe peanut allergy (age 4 years, facial urticaria and lip angioedema upon licking a peanut; peanut skin prick test, 13 x 10 mm; specific immunoglobulin (Ig) E > 100 kUA/L). At age 6, the threshold oral challenge dose was 62.5 mg. Several peanut solutions were prepared and sequentially administered at the patient's home. Over 138 days, the dose was increased from 0.625 to 5500 mg. There were 43 mild-to-moderate reactions (28% of the doses administered). Pre-LOT and post-LOT peanut IgE and IgG4 values were 265 vs 487 kUA/L, and 6.11 vs 14.8 mg/L. This is the first report of successful LOT to peanut in Spain. This home-based regimen is safe under permanent and close medical supervision by an allergist.
在西班牙，花生过敏的发病率越来越高。已经有报道称，针对多种食物，成功建立口服免疫耐受（Oral tolerance，OT）的方案。我们旨在诱导一名严重花生过敏患儿（4 岁，舔食花生后出现面部荨麻疹和唇部血管性水肿；花生皮试，13 x 10mm；特异性免疫球蛋白 E > 100 kUA/L）对花生产生临床耐受。患儿在 6 岁时的口服激发阈值剂量为 62.5mg。我们在家中为患儿准备了几种花生溶液并依次给药。在 138 天内，剂量从 0.625mg 逐渐增加至 5500mg。在此过程中，共出现 43 次轻至中度不良反应（占所给予剂量的 28%）。在口服免疫耐受前和口服免疫耐受后，患儿的花生特异性 IgE 和 IgG4 值分别为 265 和 487 kUA/L，6.11 和 14.8mg/L。这是西班牙首例成功建立花生口服免疫耐受的报告。在过敏科医生的持续密切医学监测下，该家庭治疗方案是安全的。
