Hu Alice, Lloyd Melanie, Loke Paxton, Chebar Lozinsky Adriana, O'Sullivan Michael, Quinn Patrick, Gold Michael, Tang Mimi L K
Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia; School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia.
J Allergy Clin Immunol Pract. 2023 Oct;11(10):3195-3202.e4. doi: 10.1016/j.jaip.2023.06.063. Epub 2023 Jul 7.
Food allergy adversely affects the health-related quality of life (HRQoL) of patients. It is unclear whether factors such as the reaction eliciting dose (ED) and the nature of allergic reaction symptoms affect HRQoL.
To explore associations between reaction ED or the nature of allergic symptoms and HRQoL among children with peanut allergy.
This study was a secondary analysis of baseline data from the PPOIT-003 randomized trial in 212 children aged 1 to 10 years with challenge-confirmed peanut allergy. Children's past reaction symptoms were collected by clinicians during screening. Associations between variables of interest and parent-reported child-proxy HRQoL were examined by univariable and multivariable linear regression.
Mean age of study participants was 5.9 years; 63.2% were male. Children with a low reaction ED of 80 mg peanut protein had significantly poorer HRQoL (β = -0.81; 95% CI, -1.61 to -0.00; P = .049) compared with children with a high ED of 2,500 mg peanut protein. Gastrointestinal symptoms (β = 0.45; 95% CI, 0.03-0.87; P = .037), lower airway symptoms (β = 0.46; 95% CI, 0.05-0.87; P = .030), multisystem involvement (β = 0.71; 95% CI, 0.25-1.16; P = .003), or anaphylaxis (β = 0.46; 95% CI, 0.04-0.87; P = .031) during a previous reaction were associated with worse HRQoL.
Peanut-allergic children with a lower allergen reaction threshold experienced a greater negative HRQoL impact compared with children with higher reaction thresholds. In addition, specific past allergic reaction symptoms were associated with comparatively worse HRQoL. Children experiencing these symptoms and those with lower reaction ED require increased clinical support to manage the food allergy and are likely to benefit from interventions that can improve HRQoL.
食物过敏会对患者的健康相关生活质量（HRQoL）产生不利影响。尚不清楚引发反应的剂量（ED）和过敏反应症状的性质等因素是否会影响HRQoL。
探讨花生过敏儿童的反应ED或过敏症状的性质与HRQoL之间的关联。
本研究是对PPOIT - 003随机试验的基线数据进行的二次分析，该试验纳入了212名1至10岁经激发试验确诊为花生过敏的儿童。临床医生在筛查期间收集了儿童过去的反应症状。通过单变量和多变量线性回归分析了感兴趣的变量与家长报告的儿童代理HRQoL之间的关联。
研究参与者的平均年龄为5.9岁；63.2%为男性。与花生蛋白激发剂量高（2500mg）的儿童相比，激发剂量低（80mg花生蛋白）的儿童的HRQoL显著较差（β = -0.81；95%CI，-1.61至-0.00；P = 0.049）。既往反应期间出现胃肠道症状（β = 0.45；95%CI，0.03 - 0.87；P = 0.037）、下呼吸道症状（β = 0.46；95%CI，0.05 - 0.87；P = 0.030）、多系统受累（β = 0.71；95%CI，0.25 - 1.16；P = 0.003）或过敏反应（β = 0.46；95%CI，0.04 - 0.87；P = 0.031）与较差的HRQoL相关。
与反应阈值较高的儿童相比，过敏原反应阈值较低的花生过敏儿童对HRQoL的负面影响更大。此外，既往特定的过敏反应症状与相对较差的HRQoL相关。经历这些症状的儿童和反应ED较低的儿童需要更多的临床支持来管理食物过敏，并且可能会从能够改善HRQoL的干预措施中受益。
