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探索食物过敏管理的新方法。

Exploring novel approaches to food allergy management.

机构信息

Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, Illinois.

Department of Women, Children, and Family Nursing, Rush University College of Nursing, Chicago, Illinois.

出版信息

J Am Assoc Nurse Pract. 2023 Dec 1;35(12):843-852. doi: 10.1097/JXX.0000000000000905.

Abstract

Nurse practitioners are likely to encounter pediatric and adult patients with symptoms of food allergy who need an accurate diagnosis, emergency treatment plans, and options for management. The pathophysiology of immunoglobulin E (IgE)-mediated food allergy, current and emerging diagnostics, treatment, and emergency management is briefly reviewed, and promising new and potential future treatment options are discussed. Currently, Food and Drug Administration-approved oral immunotherapy (OIT) treatment for peanut allergy, but clinical trials are underway to explore multiple-allergen OIT and alternate routes for IT such as sublingual and epicutaneous. Treatments that modulate the immune system are also potential treatments for food allergies (FAs), including biologic agents. Omalizumab, an anti-IgE therapy, dupilumab, an interleukin-4Ra receptor monoclonal antibody, and etokimab, an anti-IL-33, are all being studied for the treatment of food allergy. There is hope that these novel therapies for FAs will be a viable option translated to the practice setting in the near future, so that strict avoidance is not the only treatment plan for FAs. Nurse practitioners can support their patients with FAs and their families by keeping abreast of progress in food allergy research and assisting patients to consider novel treatment options, when appropriate, using shared decision making.

摘要

护士从业者可能会遇到有食物过敏症状的儿科和成年患者,他们需要准确的诊断、紧急治疗计划和管理选择。本文简要回顾了免疫球蛋白 E(IgE)介导的食物过敏的病理生理学、当前和新兴的诊断、治疗和紧急管理,并讨论了有前途的新的和潜在的未来治疗选择。目前,美国食品和药物管理局批准了口服免疫疗法(OIT)治疗花生过敏,但正在进行临床试验,以探索多种过敏原 OIT 和替代 IT 途径,如舌下和经皮。调节免疫系统的治疗方法也是食物过敏(FA)的潜在治疗方法,包括生物制剂。奥马珠单抗是一种抗 IgE 疗法,度普利尤单抗是一种白细胞介素-4Ra 受体单克隆抗体,依特司单抗是一种抗 IL-33,都在研究用于治疗食物过敏。人们希望这些新型 FA 治疗方法在不久的将来能够成为一种可行的选择,以便在实践中得到应用,从而使严格避免成为 FA 的唯一治疗方案。护士从业者可以通过了解食物过敏研究的进展,为 FA 患者及其家属提供支持,并在适当的时候使用共同决策,帮助患者考虑新的治疗选择。

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