Dahdah Lamia, Pecora Valentina, Riccardi Carla, Fierro Vincenzo, Valluzzi Rocco, Mennini Maurizio
University Department of Pediatrics, Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Vatican City, Italy.
Curr Opin Allergy Clin Immunol. 2018 Jun;18(3):228-233. doi: 10.1097/ACI.0000000000000446.
The prevalence of food allergy is increasing. More children are being diagnosed with food allergies, and it is taking longer to outgrow them, among those who develop tolerance. The aim of this review is to draw the profile of the persistent food allergic, so that prevention strategies can be developed and active treatment set up.
Many determinants are involved in food allergy prognosis: ethnicity and sex, type of food, innate immune system, eliciting dose, sensitization status and other biomarkers determination, gut microbiome composition, and the presence of comorbidities. Once identified, a persistent food allergy could be conveyed to active treatments, such as oral immunotherapy or the use of biologics, always taking into account their experimental nature.
A better understanding of prognostic factors and phenotypes of food allergy is crucial in decision-making when it comes to food allergy prevention and management. A good classification of the allergic patient allows to determine the degree of exclusion diets and the timing of the reintroduction of avoided food when possible. In the cases of persistent and severe food allergy, many promising interventions are emerging which could improve prognosis and quality of care.
食物过敏的患病率正在上升。越来越多的儿童被诊断出患有食物过敏，而且在那些产生耐受性的儿童中，食物过敏持续的时间也越来越长。本综述的目的是描绘持续性食物过敏患者的特征，以便制定预防策略并开展积极治疗。
食物过敏的预后涉及许多决定因素：种族和性别、食物类型、先天免疫系统、诱发剂量、致敏状态和其他生物标志物的测定、肠道微生物群组成以及合并症的存在。一旦确定为持续性食物过敏，就可以采用积极的治疗方法，如口服免疫疗法或使用生物制剂，但始终要考虑到它们的试验性质。
更好地了解食物过敏的预后因素和表型对于食物过敏的预防和管理决策至关重要。对过敏患者进行良好的分类有助于确定排除饮食的程度以及在可能的情况下重新引入避免食用食物的时机。在持续性和严重食物过敏的情况下，许多有前景的干预措施正在出现，这可能会改善预后和护理质量。
