Antolín-Amérigo Darío, Manso Luis, Caminati Marco, de la Hoz Caballer Belén, Cerecedo Inmaculada, Muriel Alfonso, Rodríguez-Rodríguez Mercedes, Barbarroja-Escudero José, Sánchez-González María José, Huertas-Barbudo Beatriz, Alvarez-Mon Melchor
Servicio de Enfermedades del Sistema Inmune-Alergia, Hospital Universitario Príncipe de Asturias. Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Carretera de Alcalá-Meco s/n, 28085 Alcalá de Henares, Madrid, Spain.
Hospital del Sureste. Arganda del Rey, Unidad de Alergia, Madrid, Spain.
Clin Mol Allergy. 2016 Feb 17;14:4. doi: 10.1186/s12948-016-0041-4. eCollection 2016.
Food allergy has increased in developed countries and can have a dramatic effect on quality of life, so as to provoke fatal reactions. We aimed to outline the socioeconomic impact that food allergy exerts in this kind of patients by performing a complete review of the literature and also describing the factors that may influence, to a greater extent, the quality of life of patients with food allergy and analyzing the different questionnaires available. Hitherto, strict avoidance of the culprit food(s) and use of emergency medications are the pillars to manage this condition. Promising approaches such as specific oral or epicutaneous immunotherapy and the use of monoclonal antibodies are progressively being investigated worldwide. However, even that an increasing number of centers fulfill those approaches, they are not fully implemented enough in clinical practice. The mean annual cost of health care has been estimated in international dollars (I$) 2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95 % confidence interval I$324-I$1530). A similar result was found for adults in each country, and for children, and interestingly, it was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. The constant threat of exposure, need for vigilance and expectation of outcome can have a tremendous impact on quality of life. Several studies have analyzed the impact of food allergy on health-related quality of life (HRQL) in adults and children in different countries. There have been described different factors that could modify HRQL in food allergic patients, the most important of them are perceived disease severity, age of the patient, peanut or soy allergy, country of origin and having allergy to two or more foods. Over the last few years, several different specific Quality of Life questionnaires for food allergic patients have been developed and translated to different languages and cultures. It is important to perform lingual and cultural translations of existent questionnaires in order to ensure its suitability in a specific region or country with its own socioeconomic reality and culture. Tools aimed at assessing the impact of food allergy on HRQL should be always part of the diagnostic work up, in order to provide a complete basal assessment, to highlight target of intervention as well as to evaluate the effectiveness of interventions designed to cure food allergy. HRQL may be the only meaningful outcome measure available for food allergy measuring this continuous burden.
食物过敏在发达国家呈上升趋势，会对生活质量产生巨大影响，甚至引发致命反应。我们旨在通过全面回顾文献，概述食物过敏对这类患者的社会经济影响，描述可能在更大程度上影响食物过敏患者生活质量的因素，并分析现有的不同问卷。迄今为止，严格避免食用致敏食物和使用应急药物是管理这种疾病的支柱。特异性口服或经皮免疫疗法以及单克隆抗体的使用等有前景的方法正在全球范围内逐步得到研究。然而，即使越来越多的中心采用了这些方法，但在临床实践中它们并未得到充分实施。据估计，2016年国际美元（I$）计算的食物过敏成人的年均医疗费用为I$2016，对照组为I$1089，相差I$927（95%置信区间I$324 - I$1530）。在每个国家的成年人以及儿童中都发现了类似的结果，有趣的是，这对基线人口统计学差异并不敏感。在九个国家的病例中，费用与疾病严重程度显著相关。接触风险的持续威胁、警惕的必要性以及对结果的预期会对生活质量产生巨大影响。几项研究分析了食物过敏对不同国家成年人和儿童健康相关生活质量（HRQL）的影响。已经描述了不同的因素可能会改变食物过敏患者的HRQL，其中最重要的是感知到的疾病严重程度、患者年龄、花生或大豆过敏、原籍国以及对两种或更多食物过敏。在过去几年中，已经为食物过敏患者开发了几种不同的特定生活质量问卷，并翻译成不同的语言和文化。对现有问卷进行语言和文化翻译很重要，以确保其在具有自身社会经济现实和文化的特定地区或国家的适用性。旨在评估食物过敏对HRQL影响的工具应始终作为诊断检查的一部分，以便提供完整的基础评估，突出干预目标以及评估旨在治愈食物过敏的干预措施的有效性。HRQL可能是衡量食物过敏这种持续负担的唯一有意义的结果指标。
