Vetander M, Protudjer J L P, Lilja G, Kull I, Hedlin G, van Hage M, Östblom E, Bergström A, Wickman M
Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Clin Exp Allergy. 2016 Dec;46(12):1575-1587. doi: 10.1111/cea.12842.
Information about severe reactions to foods in adolescence is limited.
To describe reactions to foods, including anaphylaxis, with regard to incidence, characteristics and associated risks, among 16-year-olds (adolescents) in a large, population-based birth cohort.
Parent-reported questionnaire data from ages 2-3 months, and 1, 2 and 16 years were used (N = 3153). Anaphylaxis at age 16 years was defined per NIAID/FAAN criteria. Immunoglobulin E (IgE) antibodies to 14 common food and inhalant allergens were analysed at ages 4 (n = 2283) and 16 years (n = 2510). Among adolescents with food-related symptoms (FRS) and for whom blood was available (n = 221), 25 additional food allergen extracts or allergen components were analysed. Associations between reactions to foods, and sensitization and allergic multimorbidity were investigated.
In the 12 months prior to the 16-year assessment, 8.5% of adolescents had FRS. This included 0.8% (n = 24) adolescents who were classified as having anaphylaxis, yielding an incidence rate of 761/100 000 person-years. One-third of adolescents accessed health care during anaphylaxis. Allergic multimorbidity in infancy, as well as sensitization to foods and airborne allergens at age 4 years, was associated with an increased risk for FRS in adolescence. Peanuts and tree nuts were the most common culprit foods for anaphylaxis, and fruits and vegetables for non-anaphylactic reactions. Adolescents with anaphylaxis were significantly more likely to be sensitized to storage proteins (Ara h 2, Cor a 9, Cor a 14) and to be polysensitized to foods (P < 0.001 vs. non-anaphylactic reactions).
The incidence of food-induced anaphylaxis during adolescence in our population-based birth cohort is higher than previously reported. Adolescents with anaphylaxis differ from adolescents with non-anaphylactic FRS with regard to culprit foods and sensitization. Adolescents with previous anaphylaxis are likely to be polysensitized to foods, particularly tree nut and peanut storage proteins, and which warrants consideration at follow-up.
关于青少年食物严重过敏反应的信息有限。
描述基于大规模人群的出生队列中16岁青少年（青春期）食物过敏反应，包括过敏反应的发生率、特征及相关风险。
使用2至3个月、1岁、2岁和16岁时家长报告的问卷调查数据（N = 3153）。16岁时的过敏反应根据美国国立过敏和传染病研究所/食物过敏和过敏反应网络（NIAID/FAAN）标准定义。在4岁（n = 2283）和16岁（n = 2510）时分析了针对14种常见食物和吸入性过敏原的免疫球蛋白E（IgE）抗体。在有食物相关症状（FRS）且有血液样本的青少年中（n = 221），分析了另外25种食物过敏原提取物或过敏原成分。研究了食物过敏反应与致敏及过敏性多种疾病之间的关联。
在16岁评估前的12个月中，8.5%的青少年有食物相关症状。其中包括0.8%（n = 24）被归类为过敏反应的青少年，发病率为761/100000人年。三分之一的青少年在过敏反应期间寻求医疗护理。婴儿期的过敏性多种疾病以及4岁时对食物和空气传播过敏原的致敏与青春期食物相关症状风险增加有关。花生和坚果是过敏反应最常见的致病食物，水果和蔬菜是非过敏反应的致病食物。过敏反应的青少年对储存蛋白（Ara h 2、Cor a 9、Cor a 14）致敏的可能性显著更高，并且对食物多致敏（与非过敏反应相比，P < 0.001）。
在我们基于人群的出生队列中，青春期食物诱导的过敏反应发生率高于先前报道。过敏反应的青少年与非过敏反应的食物相关症状青少年在致病食物和致敏方面存在差异。既往有过敏反应的青少年可能对食物多致敏，尤其是坚果和花生储存蛋白，这在随访中值得考虑。
