Kubala Stephanie A, Young Fernanda D, Callier Viviane, Rasooly Marjohn M, Dempsey Caeden, Brittain Erica, Frischmeyer-Guerrerio Pamela A
Food Allergy Research Section, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA.
Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA.
Allergy. 2024 Oct;79(10):2812-2825. doi: 10.1111/all.16253. Epub 2024 Aug 2.
While food allergy (FA) can be fatal, the greatest public health impact of FA arguably lies in its detrimental effect on quality of life (FAQOL). Understanding the factors that contribute to FAQOL at different ages is essential to develop personalized interventions that will improve FAQOL.
To determine the most influential factors that impact FAQOL across ages in well-phenotyped participants with confirmed FA.
One hundred and twenty-five individuals aged 2-28 years with IgE-mediated FA completed validated age-specific FAQOL questionnaires. The relationship between demographic/clinical variables and scores were analyzed to identify key predictors of FAQOL.
Poor FAQOL was associated with increasing age, strict avoidance practices, reactions to trace exposures, and more severe reactions as assessed by epinephrine use, anaphylaxis, and/or treatment in the emergency department; FAQOL improved with time from the event. FAQOL was worse in subjects avoiding >2 versus ≤2 foods and in those avoiding milk, egg, soy, sesame, or wheat. Number of foods avoided had greatest impact on children ages 2-7 years, while total number of allergic reactions strongly impacted FAQOL in teens and adults; FAQOL of subjects ages 8-12 years appeared less affected by these variables compared to other age groups. A decision tree analysis identified key predictors of overall FAQOL (age, number of food avoidances, and time since epinephrine use) that can be used to guide intervention strategies to improve FAQOL.
We directly compared FAQOL in extensively phenotyped children, teenagers, and adults with confirmed IgE-mediated FA. Age; timing, number, and severity of reactions; type and number of FA; and food avoidance practices influence FAQOL and should guide intervention strategies.
虽然食物过敏（FA）可能致命，但FA对生活质量（FAQOL）的最大公共卫生影响可能在于其对生活质量的不利影响。了解不同年龄段影响FAQOL的因素对于制定能够改善FAQOL的个性化干预措施至关重要。
确定在确诊为FA的表型良好的参与者中，影响各年龄段FAQOL的最具影响力因素。
125名年龄在2至28岁之间、患有IgE介导的FA的个体完成了经过验证的特定年龄的FAQOL问卷。分析人口统计学/临床变量与得分之间的关系，以确定FAQOL的关键预测因素。
FAQOL较差与年龄增长、严格的回避措施、对微量暴露的反应以及通过使用肾上腺素、过敏反应和/或急诊科治疗评估的更严重反应相关；FAQOL随着事件发生后的时间推移而改善。在避免超过2种食物与避免2种或更少食物的受试者中，以及在避免牛奶、鸡蛋、大豆、芝麻或小麦的受试者中，FAQOL较差。避免食物的数量对2至7岁儿童的影响最大，而过敏反应的总数对青少年和成年人的FAQOL有强烈影响；与其他年龄组相比，8至12岁受试者的FAQOL似乎受这些变量的影响较小。决策树分析确定了总体FAQOL的关键预测因素（年龄、避免食物的数量和使用肾上腺素后的时间），可用于指导改善FAQOL的干预策略。
我们直接比较了确诊为IgE介导的FA的大量表型儿童、青少年和成年人的FAQOL。年龄、反应的时间、数量和严重程度、FA的类型和数量以及食物回避措施会影响FAQOL，并应指导干预策略。
