Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Ill; Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif.
Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
J Allergy Clin Immunol. 2021 Jun;147(6):2263-2270.e5. doi: 10.1016/j.jaci.2020.11.046. Epub 2021 Feb 9.
Peanut allergy (PA) is the leading pediatric food allergy and a common cause of anaphylaxis. Little is known, however, on the prevalence and characteristics of PA in the adult population and whether phenotypic differences exist between adult-onset and childhood-onset PA.
This study describes the current US population-level burden of adult PA.
A cross-sectional food allergy survey was administered via phone and web in 2015 and 2016, resulting in nationally representative complex-survey weighted data for 40,443 adults. Reported food allergies were considered "convincing" if symptoms to specific allergens were consistent with an IgE-mediated reaction.
The prevalence of current self-reported PA was 2.9% among US adults, with 1.8% having convincing PA. Over 17% of adults with peanut allergy reported onset of their PA in adulthood. In adults with childhood-onset PA, 75.4% reported physician-diagnosed PA, compared with only 58.9% of adult-onset PA. Despite a similar frequency of food allergy-related emergency department visits within the past year (approximately 1 in 5 adults with PA allergy), adults with childhood-onset PA were significantly more likely to have a current epinephrine prescription compared with those with adult-onset PA (56% vs 44% respectively; P = .02) and were more likely to use an epinephrine autoinjector (48% vs 35%, P = .01).
Approximately 4.6 million US adults have PA-over 800,000 of whom appear to have developed their PA after age 18 years. Further examination of phenotypic differences between childhood-onset and adult-onset PA may improve understanding and management of adult PA.
花生过敏（PA）是主要的儿科食物过敏，也是引发过敏反应的常见原因。然而，人们对成年人中 PA 的流行程度和特征知之甚少，也不知道成人发病和儿童发病 PA 是否存在表型差异。
本研究描述了当前美国成年人 PA 的人群负担。
2015 年至 2016 年，通过电话和网络进行了一项横断面食物过敏调查，为 40443 名成年人提供了具有全国代表性的复杂调查加权数据。如果特定过敏原的症状与 IgE 介导的反应一致，则报告的食物过敏被认为是“可信的”。
美国成年人中当前自我报告的 PA 患病率为 2.9%，其中 1.8%为可信 PA。超过 17%的花生过敏成年人报告其 PA 发病于成年后。在儿童发病的 PA 成年人中，有 75.4%报告经医生诊断患有 PA，而成人发病的 PA 仅为 58.9%。尽管在过去一年中因食物过敏相关急诊就诊的频率相似（约每 5 个 PA 过敏成年人中就有 1 个），但与成人发病的 PA 相比，儿童发病的 PA 成年人更有可能当前有肾上腺素处方（分别为 56%和 44%；P =.02），并且更有可能使用肾上腺素自动注射器（分别为 48%和 35%，P =.01）。
大约有 460 万美国成年人患有 PA，其中有 80 多万人似乎是在 18 岁以后发病的。进一步研究儿童发病和成人发病 PA 之间的表型差异可能有助于提高对成人 PA 的理解和管理。
