Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan.
Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan.
Allergol Int. 2024 Oct;73(4):501-514. doi: 10.1016/j.alit.2024.08.002. Epub 2024 Aug 30.
Food allergies are an increasing global problem and societal issue. In addition to the potential for severe allergic reactions from accidental ingestion, food allergies impose a significant burden on the quality of life, nutrition, cost of living, and social activities of both those afflicted and their caregivers. Strict avoidance of allergens and use of emergency medications to treat allergic reactions are the traditional management and treatment strategies; however, significant progress has been made in recent years toward better treatment of food allergies. Many clinical trials on food allergen immunotherapy (oral, epicutaneous, and sublingual) have revealed its efficacy in increasing reaction thresholds and desensitization. These positive results led to the first FDA approval of peanut oral immunotherapy (OIT). However, safer and more effective approaches are required, and adjunct treatments and allergen modifications are being considered. More than 100 facilities in Japan conduct OIT, and numerous studies on it have been reported. Unlike in Europe and the US, stepwise oral food challenges with dietary guidance are conducted separately from the OIT. This review describes the current perspectives on allergen immunotherapy for the treatment of food allergies, focusing on evidence from Japan.
食物过敏是一个日益严重的全球性问题和社会问题。除了因意外摄入而导致严重过敏反应的潜在风险外，食物过敏还给患者及其护理人员的生活质量、营养、生活成本和社交活动带来了重大负担。严格避免过敏原和使用急救药物治疗过敏反应是传统的管理和治疗策略；然而，近年来在更好地治疗食物过敏方面取得了重大进展。许多关于食物过敏原免疫治疗（口服、经皮和舌下）的临床试验已经证明了其提高反应阈值和脱敏的功效。这些积极的结果导致了第一个 FDA 批准的花生口服免疫治疗（OIT）。然而，需要更安全、更有效的方法，正在考虑辅助治疗和过敏原修饰。日本有 100 多家机构进行 OIT，并且已经报告了许多相关研究。与欧洲和美国不同，日本的 OIT 是在单独进行的，与饮食指导的逐步口服食物挑战分开进行。这篇综述描述了目前针对食物过敏治疗的过敏原免疫治疗的观点，重点介绍了来自日本的证据。
