Section of Allergy and Clinical Immunology, Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada;
Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada; and.
Pediatrics. 2020 May;145(5). doi: 10.1542/peds.2019-2102. Epub 2020 Apr 17.
Peanut allergy is one of the most common food allergies in children, with increasing prevalence over time. The dual-allergen exposure hypothesis now supports transcutaneous sensitization to peanut as a likely pathophysiologic mechanism for peanut allergy development. As a result, there is emerging evidence that early peanut introduction has a role in peanut allergy prevention. Current first-line diagnostic tests for peanut allergy have limited specificity, which may be enhanced with emerging tools such as component-resolved diagnostics. Although management of peanut allergy includes avoidance and carrying an epinephrine autoinjector, risk of fatal anaphylaxis is extremely low, and there is minimal risk related to cutaneous or inhalational exposure. Quality of life in children with peanut allergy requires significant focus. Moving forward, oral and epicutaneous immunotherapy are emerging and exciting tools that may have a role to play in desensitization to peanut.
花生过敏是儿童中最常见的食物过敏之一，随着时间的推移，其患病率呈上升趋势。双过敏原暴露假说现在支持花生的经皮致敏是花生过敏发展的一种可能的病理生理机制。因此，有新的证据表明早期引入花生在预防花生过敏方面发挥作用。目前用于诊断花生过敏的一线诊断测试特异性有限，新兴工具（如成分解析诊断）可能会提高其特异性。尽管花生过敏的管理包括避免食用和携带肾上腺素自动注射器，但致命性过敏反应的风险极低，且与皮肤或吸入暴露相关的风险极小。花生过敏儿童的生活质量需要高度关注。未来，口服和经皮免疫疗法是新兴的令人兴奋的工具，可能在花生脱敏方面发挥作用。
