Allergy and Clinical Immunology Unit, San Giuseppe Moscati Hospital, 83100 Avellino, Italy.
Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy.
Nutrients. 2021 May 13;13(5):1638. doi: 10.3390/nu13051638.
Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food-along with general diagnostic and therapeutic strategies. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning their correct management. We conclude that a correct diagnostic approach and dietary control of both immune- and non-immune-mediated food-induced diseases might minimize the nutritional gaps in these patients, thus helping to improve their quality of life and reduce the economic costs of their management.
食物不良反应包括免疫介导的食物过敏和非免疫介导的不耐受。然而，这种区分和不同发病机制的参与常常混淆。此外，人们对免疫介导的食物过敏和对食物的非免疫反应的感知患病率与实际患病率之间存在差异，而这些反应极为常见。不正确识别这些反应的风险可能导致严重营养缺乏的不当饮食。本叙述性综述概述了食物免疫和非免疫不良反应的病理生理和临床特征，以及一般的诊断和治疗策略。特别强调了从胃肠病学和免疫学的综合观点来看，每种情况的具体营养关注点，试图为临床医生提供一种有用的工具，以区分这些不同的疾病实体并规划其正确的管理。我们的结论是，正确的诊断方法和对免疫和非免疫介导的食物诱导疾病的饮食控制可以最大限度地减少这些患者的营养差距，从而有助于提高他们的生活质量并降低管理的经济成本。
