Liu Mona, Burks A Wesley, Green Todd D
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Expert Rev Clin Immunol. 2015 May;11(5):673-9. doi: 10.1586/1744666X.2015.1032258. Epub 2015 Mar 31.
Allergy to tree nuts has grown widespread among patients, specifically in the pediatric population, in recent years. In this review, we evaluate and summarize the literature specific to development and treatment of tree nut allergy. The cause of tree nut allergy, such as most food allergies, is unknown; there are theories regarding maternal dietary factors as well as sensitization related to cross-reactivity to peanut allergens. The gold standard for the diagnosis of tree nut allergy is the double-blind, placebo-controlled, oral food challenge; however, simpler and more cost-effective diagnostic methods, such as the skin prick test and serum-specific IgE are often used as a supplement for diagnosis. Management of tree nut allergy consists of dietary avoidance and using epinephrine to manage serious allergic reactions. Alternative therapeutic methods, such as oral and sublingual immunotherapy and modification of allergenic proteins are being explored to develop safer, more effective and long-lasting management of tree nut allergy. We comment on the current studies involving risk factors for sensitization, diagnosis and management of tree nut allergy.
近年来，对坚果过敏在患者中，尤其是在儿科人群中变得越来越普遍。在这篇综述中，我们评估并总结了关于坚果过敏的发展和治疗的相关文献。与大多数食物过敏一样，坚果过敏的原因尚不清楚；有关于母亲饮食因素以及与花生过敏原交叉反应相关的致敏作用的理论。坚果过敏诊断的金标准是双盲、安慰剂对照的口服食物激发试验；然而，更简单且成本效益更高的诊断方法，如皮肤点刺试验和血清特异性IgE，常被用作诊断的补充手段。坚果过敏的管理包括饮食回避以及使用肾上腺素来处理严重过敏反应。正在探索替代治疗方法，如口服和舌下免疫疗法以及变应原蛋白修饰，以开发更安全、更有效且持久的坚果过敏管理方法。我们对目前涉及坚果过敏致敏、诊断和管理风险因素的研究进行了评论。
