Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences King's College London, London, United Kingdom.
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Department of Otolaryngology Head and Neck Surgery, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
J Allergy Clin Immunol. 2024 Mar;153(3):576-594. doi: 10.1016/j.jaci.2023.11.918. Epub 2023 Dec 12.
A review of the latest publications in food allergy over the past couple of years confirmed that food allergy is a major public health concern, affecting about 8% of children and 10% of adults in developed countries. The prevalence of food allergy varies around the world, with the increase being driven mainly by environmental factors, possibly together with genetic susceptibility to environmental changes. A precise diagnosis of food allergy is extremely important. Both new tests (eg, the basophil activation test) and improved optimization of information provided by existing tests (eg, the skin prick test and measurement of specific IgE level) can contribute to improving the accuracy and patients' comfort of food allergy diagnosis. Understanding the underlying immune mechanisms is fundamental to designing allergen-specific treatments that can be safe and effective in the long term. New discoveries of the immune response to food allergens, including T-cell and B-cell responses, have emerged. Novel therapeutic approaches are being trialed at various stages of development as attempts to allow for more active intervention to treat food allergy. Prevention is key to reducing the increase in prevalence. Early introduction of allergenic foods seems to be the most effective intervention, but others are being studied, and will, it is hoped, lead to modification of the epidemiologic trajectory of food allergy over time.
回顾过去几年中有关食物过敏的最新出版物,确认食物过敏是一个主要的公共卫生关注点,影响发达国家约 8%的儿童和 10%的成年人。食物过敏的患病率在全球范围内有所不同,其增加主要归因于环境因素,可能与对环境变化的遗传易感性有关。对食物过敏进行精确诊断极为重要。新的测试(例如嗜碱性粒细胞激活测试)和对现有测试(例如皮肤点刺试验和特异性 IgE 水平测量)提供的信息进行的改进优化,都有助于提高食物过敏诊断的准确性和患者的舒适度。了解潜在的免疫机制是设计过敏原特异性治疗方法的基础,这种方法在长期内可以是安全且有效的。对食物过敏原的免疫反应的新发现,包括 T 细胞和 B 细胞反应,已经出现。新的治疗方法正在各个开发阶段进行试验,试图实现更积极的干预以治疗食物过敏。预防是降低发病率增加的关键。早期引入致敏食物似乎是最有效的干预措施,但其他措施也在研究中,有望随着时间的推移改变食物过敏的流行病学轨迹。