Lavery William J, Assa'ad Amal
Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Curr Opin Allergy Clin Immunol. 2018 Jun;18(3):265-270. doi: 10.1097/ACI.0000000000000445.
The purpose of this review is to summarize recent studies and emerging consensus guidelines regarding food allergy prevention in infants of the past 5 years.
Prior to 2013, the general consensus regarding prevention of food allergy in infants was to recommend delayed introduction or complete avoidance of commonly allergenic foods, such as milk, egg and peanut. However, in the past 5 years, several landmark studies have been conducted, particularly with peanut. The results of these studies have led to a paradigm shift from recommending delayed introduction to early introduction and frequent feeding of highly allergenic foods such as peanut, with hopes of achieving primary and secondary prevention of food allergy in infants.
Recent clinical trials have demonstrated that early introduction and frequent feeding, rather than delayed introduction or complete avoidance, of commonly allergenic foods plays a critical role in preventing food allergy in infants. More studies are required to risk-stratify infants by personal and family atopic history to tailor guidelines for groups with inherently different risks. The universal acceptance of the guidelines and their application outcome are still to be determined.
本综述旨在总结过去5年中关于婴儿食物过敏预防的最新研究及新出现的共识性指南。
2013年之前，关于婴儿食物过敏预防的普遍共识是建议延迟引入或完全避免常见的致敏食物，如牛奶、鸡蛋和花生。然而，在过去5年中，开展了多项具有里程碑意义的研究，尤其是关于花生的研究。这些研究结果导致了一种范式转变，即从建议延迟引入转变为早期引入并频繁喂食高致敏性食物，如花生，以期实现婴儿食物过敏的一级和二级预防。
近期临床试验表明，早期引入并频繁喂食常见的致敏食物，而非延迟引入或完全避免，在预防婴儿食物过敏中起关键作用。需要更多研究根据个人和家族特应性病史对婴儿进行风险分层，以针对具有不同固有风险的群体制定指南。这些指南的普遍接受程度及其应用效果仍有待确定。
