a Jaffe Food Allergy Institute, Division of Pediatric Allergy and Immunology , Icahn School of Medicine at Mount Sinai , New York , NY , USA.
Expert Rev Clin Immunol. 2019 May;15(5):487-495. doi: 10.1080/1744666X.2019.1582331. Epub 2019 Mar 11.
Peanut allergy appears to have increased in prevalence, is often severe and is typically life-long. Therefore, reducing its incidence through a primary prevention strategy is a priority. Guidelines on peanut introduction have evolved with time and given evidence of peanut allergy risk reduction with early infant ingestion exposure, the current US advice promotes early introduction for infants, particularly targeting those at highest risk. Areas covered: This article describes the evolution of peanut introduction guidelines in infants in the US, as shaped by key research over the last 20-30 years and culminates in the landmark LEAP study. It also compares and contrasts current iterations of peanut introduction guidelines in infants globally. Finally, the early successes and barriers of implementation of early peanut introduction guidelines are discussed. We included literature from original articles, reviews, and consensus guidelines found in database searches through December 2018. Expert commentary: LEAP guideline implementation has proven to be successful, in the study setting, in decreasing the incidence of peanut allergy. However, its implementation in the community has been met with obstacles including low awareness among stakeholders, and access to testing when needed.
花生过敏的发病率似乎有所增加，通常较为严重且往往是终身的。因此，通过初级预防策略来降低其发病率是当务之急。随着时间的推移，关于花生引入的指南也在不断发展，并且早期婴儿摄入暴露已证明可降低花生过敏的风险，因此目前美国的建议提倡婴儿尽早引入花生，特别是针对那些风险最高的婴儿。涵盖领域：本文描述了过去 20-30 年来美国婴儿花生引入指南的演变，这些指南是由关键研究塑造的，并最终以具有里程碑意义的 LEAP 研究为高潮。它还比较和对比了全球目前婴儿花生引入指南的迭代。最后，讨论了早期引入花生指南的早期成功和实施障碍。我们纳入了数据库检索中原始文章、综述和共识指南中的文献，检索时间截至 2018 年 12 月。专家评论：LEAP 指南的实施已被证明在研究环境中可成功降低花生过敏的发病率。然而，其在社区中的实施遇到了一些障碍，包括利益相关者的意识较低，以及在需要时获得检测的机会有限。
