Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy.
Pediatric Clinic, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
Pediatr Allergy Immunol. 2019 Jun;30(4):415-422. doi: 10.1111/pai.13042. Epub 2019 Mar 12.
IgE-mediated food allergy (FA) is a potentially life-threatening condition with a negative impact on quality of life and an increasing prevalence in westernized countries in the recent two decades. A strict avoidance of the triggering food(s) represents the current standard approach. However, an elimination diet may be difficult and frustrating, in particular for common foods, (eg, milk, egg, and peanut). Food allergy immunotherapy (FA-AIT) may provide an active treatment that enables to increase the amount of food that the patient can intake without reaction during treatment (ie, desensitization), and reduces the risk of potential life-threatening allergic reaction in the event of accidental ingestion. However, several gaps need still to be filled. A memorable Latin orator stated: "Est modus in rebus" (Horace, Sermones I, 1, 106-07). This sentence remembers that there is a measure in everything to a proper proportion of therapy. The common sense of measure should find application in each stage of treatment. A personalized approaching should consider the specific willing and features of each patient. Efforts are devoted to improve the efficacy, the safety but also the quality of life of patients suffering from FA. In the near future, it will be important to clarify immunologic pathways of FA-AIT, and to identify reliable biomarkers in order to recognize the most suitable candidates to FA-AIT and algorithms for treatments tailored on well-characterized subpopulations of patients.
免疫球蛋白 E（IgE）介导的食物过敏（FA）是一种潜在的危及生命的疾病，对生活质量有负面影响，并且在近二十年来西方国家的发病率不断上升。目前的标准方法是严格避免食用触发食物。然而，消除饮食可能很困难且令人沮丧，特别是对于常见食物（例如牛奶、鸡蛋和花生）。食物过敏免疫治疗（FA-AIT）可能提供一种积极的治疗方法，可以增加患者在治疗过程中无反应摄入食物的量（即脱敏），并降低在意外摄入时发生潜在危及生命的过敏反应的风险。然而，仍有几个空白需要填补。一位令人难忘的拉丁演说家曾说过：“Est modus in rebus”（贺拉斯，《演说家》I，1，106-07）。这句话提醒我们，一切都有一个适当的治疗比例的衡量标准。适度的常识应该适用于治疗的每个阶段。个性化的方法应该考虑每个患者的具体意愿和特征。目前正在努力提高 FA 患者的疗效、安全性和生活质量。在不久的将来，重要的是要阐明 FA-AIT 的免疫途径，并确定可靠的生物标志物，以便识别最适合 FA-AIT 的候选者，并为针对患者明确特征亚群的量身定制治疗制定算法。
