University of Antwerp, Faculty Medicine and Health Sciences, Department Immunology - Allergology - Rheumatology, Campus Drie Eiken T4.08, Universiteitsplein 1, B 2610 Antwerpen.
Curr Pharm Des. 2014;20(6):964-72. doi: 10.2174/13816128113199990045.
Currently management of food allergy is mainly based on absolute avoidance of the offending food(s) and the use of rescue medication. However, the risk of severe or life-threatening reactions due to inadvertent exposure, nutritional imbalance and social isolation raises the demand of disease-modifying treatments. The aim of the different treatments is to allow patients to safely ingest the offending food(s). However this unresponsiveness can be transient and requires continued treatment (desensitization) and has to be permanent and sustained also after stopping the treatment (tolerance). This review focuses on non-allergen specific (anti-IgE, Chinese herbal formula, etc..) and allergen specific treatments for food allergy. The anti-IgE treatment is at the moment the only non-allergen-specific therapy, for which some data on a temporarily clinical efficacy have been provided. Regarding allergen-specific treatments, different protocols (oral, sublingual, subcutaneous and epicutaneous) with natural, heat treated or recombinant food allergens have been investigated. Although promising, results of the different clinical trials are heterogeneous. In particular data on long-term effects are lacking. At the moment food specific immunotherapy can be considered an experimental interventional strategy, limited to research, and not yet ready for routine use.
目前，食物过敏的管理主要基于绝对避免食用过敏原食物和使用急救药物。然而，由于意外暴露、营养失衡和社会隔离而导致严重或危及生命的反应的风险，提高了对疾病修正治疗的需求。不同治疗方法的目的是使患者能够安全摄入过敏原食物。然而，这种无反应性可能是短暂的，需要持续治疗（脱敏），并且在停止治疗后也必须是永久性和持续的（耐受）。这篇综述重点介绍了非过敏原特异性（抗 IgE、中药配方等）和过敏原特异性治疗食物过敏的方法。抗 IgE 治疗目前是唯一的非过敏原特异性疗法，已经提供了一些关于其暂时临床疗效的数据。关于过敏原特异性治疗，已经研究了不同的方案（口服、舌下、皮下和皮内），使用天然、热处理或重组食物过敏原。尽管有希望，但不同临床试验的结果存在异质性。特别是缺乏长期效果的数据。目前，食物特异性免疫疗法可以被认为是一种实验性的干预策略，仅限于研究，还没有准备好常规使用。
