Borres Magnus P, Sato Sakura, Ebisawa Motohiro
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
World Allergy Organ J. 2022 Apr 11;15(4):100641. doi: 10.1016/j.waojou.2022.100641. eCollection 2022 Apr.
Tree nuts are a powerful and common source of food allergens that induce IgE-mediated allergic reactions. Health authorities endorse the intake of tree nuts because they are regarded as nutritious. Allergic reactions to nuts can lead to severe and occasionally lethal reactions. Allergies to tree nuts are observed worldwide and are found in up to 4.9% of people in unspecific populations. Over the last 2 decades, the rates of allergic reactions and anaphylaxis have increased in different countries. Most proteins implicated in tree nut allergic reactions are members of the lipid transfer protein, 2S albumin, vicilin, legumin, and oleosin protein families. Bet v 1 homologs and profilins are involved in pollen-related tree nut allergies. Systematic literature reviews and meta-analyses on the diagnostic accuracy of specific immunoglobulin E (sIgE) for commercially available nut components have recently been published. IgE testing of the storage proteins Cor a 14, Cor a 9, Jug r 1, and Ana o 3 increases diagnostic specificity in assessing hazelnut, walnut, and cashew allergies in children, respectively. The resolution of tree nut allergies has been reported; however, only a few studies are available in this regard. Complete avoidance of nuts is the safest approach for nut-allergic subjects. However, this is difficult to achieve and can result in a severely restricted diet. Patients can eat nuts that they know are safe at home, but should avoid them when eating out because of the risk of cross-contamination. Nuts have become part of a modern healthy diet, and this enhanced consumption is reflected in an increased prevalence of nut allergies.
坚果是引发IgE介导过敏反应的一种常见且强效的食物过敏原来源。卫生当局认可食用坚果，因为它们被认为营养丰富。对坚果的过敏反应可能导致严重甚至致命的后果。坚果过敏在全球范围内都有发现，在非特定人群中，高达4.9%的人存在坚果过敏。在过去20年里，不同国家的过敏反应和过敏症发生率都有所上升。大多数与坚果过敏反应相关的蛋白质是脂质转移蛋白、2S白蛋白、豌豆球蛋白、豆球蛋白和油质蛋白家族的成员。Bet v 1同源物和肌动蛋白结合蛋白与花粉相关的坚果过敏有关。最近发表了关于特定免疫球蛋白E（sIgE）对市售坚果成分诊断准确性的系统文献综述和荟萃分析。对储存蛋白Cor a 14、Cor a 9、Jug r 1和Ana o 3进行IgE检测，分别提高了评估儿童榛子、核桃和腰果过敏时的诊断特异性。已有关于坚果过敏缓解的报道；然而，这方面的研究较少。对于坚果过敏的受试者，完全避免食用坚果是最安全的方法。然而，这很难做到，并且可能导致饮食受到严重限制。患者在家中可以食用他们知道安全的坚果，但外出就餐时应避免食用，因为存在交叉污染的风险。坚果已成为现代健康饮食的一部分，这种消费的增加反映在坚果过敏患病率的上升上。
