Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
Department of Pediatrics, Division of Pediatric Allergy/Immunology, National Jewish Health, Denver, Colo.
J Allergy Clin Immunol. 2014 Feb;133(2):324-34. doi: 10.1016/j.jaci.2013.11.013. Epub 2013 Dec 25.
This review highlights some of the research advances in anaphylaxis; hypersensitivity reactions to foods, drugs, and insects; and allergic skin diseases that were reported in the Journal in 2013. Studies on food allergy suggest that (1) 7.6% of the US population is affected, (2) a "healthy" early diet might prevent food allergy, (3) the skin might be an important route of sensitization, (4) allergen component testing might aid diagnosis, (5) the prognosis of milk allergy might be predictable through early testing, (6) oral or sublingual immunotherapy show promise but also have caveats, and (7) preclinical studies show promising alternative modes of immunotherapy and desensitization. Studies on eosinophilic esophagitis show a relationship to connective tissue disorders and that dietary management is an effective treatment for adults. Markers of anaphylaxis severity have been determined and might inform potential diagnostics and therapeutic targets. Insights on serum tests for drug and insect sting allergy might result in improved diagnostics. Genetic and immune-mediated defects in skin epithelial differentiation contribute to the severity of atopic dermatitis. Novel management approaches to treatment of chronic urticaria, including use of omalizumab, are being identified.
本文回顾了 2013 年《过敏与临床免疫学杂志》发表的一些过敏反应、食物、药物和昆虫过敏及过敏性皮肤病的研究进展。食物过敏的研究表明：（1）美国有 7.6%的人群受其影响；（2）“健康”的早期饮食可能预防食物过敏；（3）皮肤可能是致敏的重要途径；（4）过敏原成分检测可能有助于诊断；（5）早期检测可能预测牛奶过敏的预后；（6）口服或舌下免疫治疗有前景，但也有局限性；（7）临床前研究显示免疫疗法和脱敏疗法有替代模式。嗜酸性食管炎的研究表明其与结缔组织疾病有关，饮食管理是成人的有效治疗方法。过敏反应严重程度的标志物已经确定，可能为潜在的诊断和治疗靶点提供信息。药物和昆虫叮咬过敏血清检测的相关见解可能会改善诊断。皮肤上皮分化的遗传和免疫介导缺陷导致特应性皮炎的严重程度。正在确定治疗慢性荨麻疹的新管理方法，包括使用奥马珠单抗。
