Department of Allergy and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Allergol Int. 2016 Oct;65(4):388-395. doi: 10.1016/j.alit.2016.08.002. Epub 2016 Sep 13.
Food allergy has grown in rapidly in prevalence, currently affecting 5% of adults and 8% of children. Management strategy is currently limited to 1) food avoidance and 2) carrying and using rescue intramuscular epinephrine/adrenaline and oral antihistamines in the case of accidental ingestion; there is no FDA approved treatment. Recently, oral, sublingual and epicutaneous immunotherapy have been developed as active treatment of food allergy, though none have completed phase 3 study. Efficacy and safety studies of immunotherapy have been variable, though there is clearly signal that immunotherapy will be a viable option to desensitize patients. The use of bacterial adjuvants, anti-IgE monoclonal antibodies, and Chinese herbal formulations either alone or in addition to immunotherapy may hold promise as future options for active treatment. Active prevention of food allergy through early introduction of potentially offending foods in high-risk infants will be an important means to slow the rising incidence of sensitization.
食物过敏的发病率迅速上升，目前影响 5%的成年人和 8%的儿童。管理策略目前仅限于 1）避免食用和 2）在意外摄入时携带和使用肌内注射肾上腺素/去甲肾上腺素和口服抗组胺药进行急救；目前尚无 FDA 批准的治疗方法。最近，口服、舌下和皮内免疫疗法已被开发为食物过敏的主动治疗方法，但没有一种方法完成了 3 期研究。免疫疗法的疗效和安全性研究结果各不相同，但显然有信号表明免疫疗法将是一种使患者脱敏的可行选择。细菌佐剂、抗 IgE 单克隆抗体和中草药制剂单独或联合免疫疗法的使用可能是未来主动治疗的有希望的选择。通过在高风险婴儿中早期引入潜在致敏食物来主动预防食物过敏，将是减缓致敏发生率上升的重要手段。
