Operative Unit of Pediatrics, S. Camillo-Forlanini Hospital, Rome, Italy.
Department of Pediatrics, Sapienza University of Rome, Rome, Italy.
Pediatr Allergy Immunol. 2020 Feb;31 Suppl 24:49-50. doi: 10.1111/pai.13171.
The avoidance of allergenic foods and emergency medications on accidental exposure are the only currently approved treatments in food allergy. EAACI guideline on allergen immunotherapy recommends oral immunotherapy as a therapeutic option to increase the threshold of the reaction during treatment in children with persistent IgE-mediated cow's milk, hen's egg, and peanut allergy from around 4-5 years of age, but the same recommendation cannot currently be made to achieve post-discontinuation effectiveness. Both systemic and local reactions during OIT have been frequently reported. For this reason, EAACI guideline suggests several recommendations on safety, including carefully monitoring patients for allergic reactions, especially during the up-dosing phase of OIT, and monitoring for symptoms of new-onset eosinophilic esophagitis. New approaches are certainly necessary to give priority not only to effectiveness but also to safety.
在食物过敏中，避免食用过敏原食物和紧急情况下使用药物是目前唯一被认可的治疗方法。过敏免疫治疗 EAACI 指南建议口服免疫治疗作为一种治疗选择，以增加持续性 IgE 介导的牛奶、鸡蛋和花生过敏儿童在治疗过程中反应的阈值，年龄约为 4-5 岁，但目前不能推荐同样的建议来实现停药后的效果。OIT 期间经常报告有全身性和局部反应。为此，EAACI 指南就安全性提出了几项建议，包括仔细监测患者的过敏反应，特别是在 OIT 的加量阶段，并监测新出现的嗜酸性食管炎的症状。当然，需要采取新的方法，不仅要重视疗效，还要重视安全性。
