Young Michael C
Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Pediatr. 2015 Dec;27(6):736-40. doi: 10.1097/MOP.0000000000000291.
The paradigm for the primary prevention of peanut allergy was, until recently, strict avoidance of peanut during pregnancy, infancy, and early childhood. However, in countries that had these dietary guidelines, the prevalence of peanut allergy greatly increased in contrast to low prevalence rates of peanut allergy in countries where infant diets included peanut at an early age, suggesting the hypothesis that early introduction of peanut is superior to delayed introduction of peanut as a strategy for the primary prevention of food allergy. This review examines recent high-quality studies that support this hypothesis.
Publication of the Learning Early about Allergy to Peanut interventional trial showed that 17% of children avoiding peanut until 5 years of age developed peanut allergy compared with 3% of children who started eating peanut at ages of 4-11 months. Two birth cohort studies demonstrated that high maternal consumption of peanut during the pregnancy period reduced the risk of peanut allergy in offspring by 50-75%.
Recent studies indicate that early introduction of peanut enhances the development of tolerance to peanut, reducing the risk of childhood peanut allergy.
直到最近，花生过敏一级预防的范例仍是在孕期、婴儿期和幼儿期严格避免食用花生。然而，在有这些饮食指南的国家，花生过敏的患病率大幅上升，与之形成对比的是，在婴儿饮食早期就包含花生的国家，花生过敏患病率较低，这提示了这样一个假设：作为食物过敏一级预防策略，早期引入花生优于延迟引入花生。本综述审视了支持这一假设的近期高质量研究。
“早期了解花生过敏”干预试验的发表表明，5岁前一直避免食用花生的儿童中，17%出现了花生过敏，而在4至11个月开始食用花生的儿童中，这一比例为3%。两项出生队列研究表明，孕期母亲大量食用花生可使后代患花生过敏的风险降低50%至75%。
近期研究表明，早期引入花生可增强对花生的耐受性发展，降低儿童期花生过敏的风险。
