Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
J Intern Med. 2022 Mar;291(3):283-302. doi: 10.1111/joim.13422. Epub 2021 Dec 22.
Adverse reactions after food intake are commonly reported and a cause of concern and anxiety that can lead to a very strict diet. The severity of the reaction can vary depending on the type of food and mechanism, and it is not always easy to disentangle different hypersensitivity diagnoses, which sometimes can exist simultaneously. After a carefully taken medical history, hypersensitivity to food can often be ruled out or suspected. The most common type of allergic reaction is immunoglobulin E (IgE)-mediated food allergy (prevalence 5-10%). Symptoms vary from mild itching, stomach pain, and rash to severe anaphylaxis. The definition of IgE-mediated food allergy is allergic symptoms combined with specific IgE-antibodies, and therefore only IgE-antibodies to suspected allergens should be analyzed. Nowadays, methods of molecular allergology can help with the diagnostic process. The most common allergens are milk and egg in infants, peanut and tree nuts in children, and fish and shellfish in adults. In young children, milk/egg allergy has a good chance to remit, making it important to follow up and reintroduce the food when possible. Other diseases triggered by food are non-IgE-mediated food allergy, for example, eosinophilic esophagitis, celiac disease, food protein-induced enterocolitis syndrome, and hypersensitivity to milk and biogenic amines. Some of the food hypersensitivities dominate in childhood, others are more common in adults. Interesting studies are ongoing regarding the possibilities of treating food hypersensitivity, such as through oral immunotherapy. The purpose of this review was to provide an overview of the most common types of food hypersensitivity reactions.
进食后出现不良反应较为常见，这些反应不仅令人担忧和焦虑，还可能导致患者严格限制饮食。反应的严重程度取决于食物类型和机制，而且有时很难明确区分不同的过敏诊断，这些诊断有时可能同时存在。仔细询问病史后，通常可以排除或怀疑食物过敏。最常见的过敏反应类型是免疫球蛋白 E（IgE）介导的食物过敏（发病率为 5-10%）。症状从轻度瘙痒、腹痛和皮疹到严重过敏反应不等。IgE 介导的食物过敏的定义是过敏症状合并特异性 IgE 抗体，因此仅应分析可疑过敏原的 IgE 抗体。如今，分子过敏学方法有助于诊断过程。最常见的过敏原是婴儿的牛奶和鸡蛋、儿童的花生和树坚果以及成人的鱼和贝类。在幼儿中，牛奶/鸡蛋过敏有很好的缓解机会，因此随访并在可能时重新引入食物很重要。由食物引发的其他疾病是非 IgE 介导的食物过敏，例如嗜酸性食管炎、乳糜泻、食物蛋白诱导的肠病综合征和对牛奶和生物胺的过敏。一些食物过敏在儿童期更为常见，另一些则在成年期更为常见。目前正在进行一些关于治疗食物过敏的有趣研究，例如通过口服免疫疗法。本文旨在概述最常见的食物过敏反应类型。
