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食物过敏的未来:挑战临床实践的现有范式。

The future of food allergy: Challenging existing paradigms of clinical practice.

机构信息

Department of Pediatrics, Section of Immunology, Allergy and Retrovirology, Texas Children's Hospital, Houston, Texas, USA.

Section of Allergy, Immunology & Retrovirology, Baylor College of Medicine, Houston, Texas, USA.

出版信息

Allergy. 2023 Jul;78(7):1847-1865. doi: 10.1111/all.15757. Epub 2023 May 11.

Abstract

The field of food allergy has seen tremendous change over the past 5-10 years with seminal studies redefining our approach to prevention and management and novel testing modalities in the horizon. Early introduction of allergenic foods is now recommended, challenging the previous paradigm of restrictive avoidance. The management of food allergy has shifted from a passive avoidance approach to active interventions that aim to provide protection from accidental exposures, decrease allergic reaction severity and improve the quality of life of food-allergic patients and their families. Additionally, novel diagnostic tools are making their way into clinical practice with the goal to reduce the need for food challenges and assist physicians in the-often complex-diagnostic process. With all the new developments and available choices for diagnosis, prevention and therapy, shared decision-making has become a key part of medical consultation, enabling patients to make the right choice for them, based on their values and preferences. Communication with patients has also become more complex over time, as patients are seeking advice online and through social media, but the information found online may be outdated, incorrect, or lacking in context. The role of the allergist has evolved to embrace all the above exciting developments and provide patients with the optimal care that fits their needs. In this review, we discuss recent developments as well as the evolution of the field of food allergy in the next decade.

摘要

在过去的 5-10 年中,食物过敏领域发生了巨大的变化,开创性的研究重新定义了我们预防和管理食物过敏的方法,新的检测模式也即将出现。现在建议早期引入致敏食物,这对以前的限制回避模式提出了挑战。食物过敏的管理已经从被动回避方法转变为主动干预,旨在提供对意外暴露的保护,降低过敏反应的严重程度,并提高食物过敏患者及其家人的生活质量。此外,新的诊断工具正在进入临床实践,其目的是减少食物挑战的需求,并帮助医生进行复杂的诊断过程。随着所有新的发展和可用于诊断、预防和治疗的选择,共同决策已成为医疗咨询的一个关键部分,使患者能够根据自己的价值观和偏好做出正确的选择。随着时间的推移,与患者的沟通也变得更加复杂,因为患者在网上和社交媒体上寻求建议,但网上的信息可能已经过时、不正确或缺乏背景。过敏专家的角色已经发展到包括所有这些令人兴奋的发展,并为患者提供符合其需求的最佳护理。在这篇综述中,我们讨论了最近的发展以及未来十年食物过敏领域的演变。

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