Meyer Rosan, Chebar Lozinsky Adriana, Fleischer David M, Vieira Mario C, Du Toit George, Vandenplas Yvan, Dupont Christophe, Knibb Rebecca, Uysal Piınar, Cavkaytar Ozlem, Nowak-Wegrzyn Anna, Shah Neil, Venter Carina
Department Paediatrics, Imperial College London, London, UK.
Department of Allergy and Immune Disorders, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Allergy. 2020 Jan;75(1):14-32. doi: 10.1111/all.13947. Epub 2019 Aug 27.
It is well-established that food proteins, such as egg, soya, cow's milk and wheat, are detectable in breastmilk for many hours or days after ingestion. Exposure to these proteins is important to the process of developing tolerance but can also sometimes elicit IgE-mediated and non-IgE-mediated allergic symptoms in breastfed infants. Non-IgE-mediated allergy, outside of food protein-induced allergic proctocolitis and eosinophilic oesophagitis, is not well understood, leading to variations in the diagnosis and management thereof. A primary objective of the European Academy for Allergy and Clinical Immunology is to support breastfeeding in all infants, including those with food allergies. A Task Force was established, to explore the clinical spectrum of non-IgE-mediated allergies, and part of its objectives was to establish diagnosis and management of non-IgE-mediated allergies in breastfed infants. Eight questions were formulated using the Patient, Intervention, Comparison, Outcome (PICO) system and Scottish Intercollegiate Guideline Network (SIGN) criteria for data inclusion, and consensus was achieved on practice points through the Delphi method. This publication aims to provide a comprehensive overview on this topic with practice points for healthcare professionals.
众所周知，食物蛋白，如鸡蛋、大豆、牛奶和小麦，在摄入后数小时或数天内可在母乳中检测到。接触这些蛋白质对形成耐受性的过程很重要，但有时也会在母乳喂养的婴儿中引发IgE介导和非IgE介导的过敏症状。除了食物蛋白诱导的过敏性直肠结肠炎和嗜酸性食管炎外，非IgE介导的过敏尚未得到很好的理解，导致其诊断和管理存在差异。欧洲变态反应和临床免疫学会的一个主要目标是支持所有婴儿进行母乳喂养，包括那些患有食物过敏的婴儿。为此成立了一个特别工作组，以探索非IgE介导的过敏的临床范围，其部分目标是确定母乳喂养婴儿中非IgE介导的过敏的诊断和管理方法。使用患者、干预措施、对照、结果（PICO）系统和苏格兰校际指南网络（SIGN）的数据纳入标准提出了八个问题，并通过德尔菲法就实践要点达成了共识。本出版物旨在为医疗保健专业人员提供关于该主题的全面概述及实践要点。
