Cunico Daniela, Giannì Giuliana, Scavone Sara, Buono Enrico Vito, Caffarelli Carlo
Clinica Pediatrica, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy.
Children (Basel). 2024 Oct 26;11(11):1295. doi: 10.3390/children11111295.
Asthma and food allergy are two complex allergic diseases with an increasing prevalence in childhood. They share risk factors, including atopic family history, atopic dermatitis, allergen sensitization, and T2 inflammatory pathways. Several studies have shown that in children with a food allergy, the risk of developing asthma, particularly in early childhood, is high. Food allergen intake or the inhalation of aerosolized allergens can induce respiratory symptoms such as bronchospasm. Patients with both conditions have an increased risk of severe asthma exacerbations, hospitalization, and mortality. The current management of clinical food hypersensitivity primarily involves the dietary avoidance of food allergens and the use of self-injectable adrenaline for severe reactions. Poorly controlled asthma limits the prescription of oral immunotherapy to foods, which has emerged as an alternative therapy for managing food allergies. Biological therapies that are effective in severe asthma have been explored for treating food allergies. Omalizumab improves asthma control and, either alone or in combination with oral immunotherapy, increases the threshold of allergen tolerance. Understanding the interplay between asthma and food allergy is crucial for developing successful treatment approaches and ameliorating patient results.
哮喘和食物过敏是两种复杂的过敏性疾病,在儿童中的患病率呈上升趋势。它们有共同的风险因素,包括特应性家族史、特应性皮炎、过敏原致敏和2型炎症途径。多项研究表明,患有食物过敏的儿童,尤其是在幼儿期,患哮喘的风险很高。摄入食物过敏原或吸入雾化过敏原可诱发支气管痉挛等呼吸道症状。同时患有这两种疾病的患者,严重哮喘发作、住院和死亡的风险会增加。目前临床食物过敏的管理主要包括饮食中避免食物过敏原以及在严重反应时使用可自行注射的肾上腺素。控制不佳的哮喘限制了食物口服免疫疗法的处方,而口服免疫疗法已成为治疗食物过敏的一种替代疗法。人们已经探索了对严重哮喘有效的生物疗法来治疗食物过敏。奥马珠单抗可改善哮喘控制,单独使用或与口服免疫疗法联合使用时,可提高过敏原耐受阈值。了解哮喘和食物过敏之间的相互作用对于制定成功的治疗方法和改善患者预后至关重要。