Department Paediatrics, Imperial College, London, UK.
Department of Paediatric Allergy, Evelina London Children's Hospital, London, UK.
Pediatr Allergy Immunol. 2019 Mar;30(2):149-158. doi: 10.1111/pai.13000. Epub 2019 Jan 10.
The rise in food allergy has been described as the "second wave" of the allergy epidemic, with some developed countries reporting a prevalence of 10% of challenge-proven food allergies. Recognition of the Allergic March has played a crucial role in identifying causality in allergic conditions, linking atopic dermatitis to food allergy and food allergy to other atopic disorders, thereby highlighting opportunities in prevention and the importance of early intervention. This publication will establish the value of weaving the less well-understood, non-IgE-mediated food allergy into the Allergic March and mapping its progression through childhood and its associated co-morbidities. The proposed non-IgE-mediated Allergic March highlights the concomitant presentation of gastrointestinal symptoms and atopic dermatitis as early presenting symptoms in confirmed non-IgE-mediated allergies and the later development of atopic co-morbidities, including asthma and allergic rhinitis, similar to the IgE-mediated Allergic March. This publication highlights recent observations of a link between non-IgE-mediated food allergy in early childhood and functional gastrointestinal disorders in later life and also the reported occurrence of extra-intestinal manifestations at later ages. Although significant limitations exist in regard to the proposed evolution of the Allergic March model, the authors hope that this publication will influence the management of non-IgE-mediated gastrointestinal allergies and inform future research and interventions.
食物过敏的增加被描述为过敏流行的“第二波”，一些发达国家报告称，经证实的食物过敏患病率为 10%。对过敏进展的认识在确定过敏状况的因果关系方面发挥了至关重要的作用，将特应性皮炎与食物过敏联系起来，并将食物过敏与其他特应性疾病联系起来，从而突出了预防的机会和早期干预的重要性。本出版物将确定将了解较少的非 IgE 介导的食物过敏纳入过敏进展并描绘其在儿童期的进展及其相关合并症的价值。拟议的非 IgE 介导的过敏进展突出了胃肠道症状和特应性皮炎作为已确认的非 IgE 介导过敏的早期表现以及随后出现特应性合并症（包括哮喘和过敏性鼻炎）的同时出现，类似于 IgE 介导的过敏进展。本出版物强调了最近观察到的儿童早期非 IgE 介导的食物过敏与以后生活中的功能性胃肠道疾病之间的联系，以及报告的在以后年龄出现的肠外表现。尽管在过敏进展模型的拟议演变方面存在重大局限性，但作者希望本出版物将影响非 IgE 介导的胃肠道过敏的管理，并为未来的研究和干预措施提供信息。
