Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK.
Pediatr Allergy Immunol. 2012 Dec;23(8):698-706. doi: 10.1111/pai.12025.
This review highlights the progress made in food allergy (FA) and anaphylaxis research in pediatrics published in the journal Pediatric Allergy and Immunology since 2010. Putative risk factors for FA are as follows: a family history of allergic disease, particularly in the mother, low birth order, season of birth, and severe atopic eczema. Obstetric practices, antibiotic use, and home environment are factors deserving further research. Diagnostic decision levels and component-specific IgE are useful in the diagnosis of FA; however, oral food challenges remain the gold standard and may also be a means to reduce parental anxiety and to improve education. Oral immunotherapy studies show promise in increasing the threshold of reactivity of allergic patients and therefore improving their quality of life. In single-nut-allergic patients, introduction of other nuts allows broadening the diet and thus reducing the psychological impact of allergen avoidance. Nutritional deficiencies are not uncommon in food-allergic children and should be specifically assessed. The prescription of injectable adrenaline is still insufficient and not consistent among practitioners, requiring improved training and implementation of guidelines. Current research into the epidemiology and immunological mechanisms of FA and tolerance will enable us to devise strategies to both prevent and treat food allergies.
这篇综述强调了自 2010 年以来在《儿科过敏与免疫学》杂志上发表的儿科食物过敏（FA）和过敏反应研究的进展。FA 的潜在危险因素如下：家族过敏病史，特别是母亲，低出生顺序，出生季节和严重特应性皮炎。产科实践、抗生素使用和家庭环境是值得进一步研究的因素。诊断决策水平和特定 IgE 对 FA 的诊断有用；然而，口服食物挑战仍然是金标准，也可能是减轻父母焦虑和改善教育的一种手段。口服免疫治疗研究表明，增加过敏患者反应阈值的前景良好，从而提高他们的生活质量。在单一坚果过敏患者中，引入其他坚果可以拓宽饮食范围，从而减少对过敏原回避的心理影响。食物过敏儿童中并不罕见营养缺乏，应进行专门评估。注射用肾上腺素的处方仍然不足且在从业者中不一致，需要改进培训和实施指南。目前对 FA 和耐受的流行病学和免疫学机制的研究将使我们能够制定预防和治疗食物过敏的策略。
