食物过敏的初级预防
2017/07/24
摘要
据估计，在美国大约有8%的儿童受食物过敏影响。食物过敏目前尚无法治疗或治愈，且在部分患者中，可能相当严重甚至威胁生命。尽管近期对潜在治疗方法的研究取得重要进展，已有2种食物靶向的免疫治疗产品进入III期临床试验阶段，但该领域最大的突破可能在于避免高危人群产生食物过敏的潜在预防性策略的提出。过去5年中多项随机对照试验（RCTs）均表明，早期过敏原接触可显著降低食物过敏风险，其中包括出生后第一年内开始的2项早期花生引入试验和5项早期鸡蛋引入试验。这些结果表明，通过早期接触过敏原进行食物过敏的初级预防，可能避免数以万计的儿童发生食物过敏。根据上述花生试验的结果，美国国家过敏与感染疾病协会最近在“2010年食品过敏指南”中添加了一则附录，特别推荐为高风险及一般风险的婴儿食物中加入花生，以降低他们形成花生过敏的风险，但对鸡蛋目前尚无正式推荐。本综述将聚焦支持早期接触作为预防食物过敏策略的最新研究以及其成功应用的实践性因素。
Primary Prevention of Food Allergy.
Greenhawt MJ, Fleischer DM.
Abstract
Food allergy is estimated to affect approximately 8% of children in the USA. This is a disease without any known treatment or cure and, for some, a disease that can be quite severe, even life-threatening. While recent advances in potential treatment have made remarkable strides, with two food-targeted immunotherapy products now in phase III trials, perhaps the biggest gains in the field have come in the advent of potential preventative strategies to avoid the development of food allergy in high-risk individuals. There have been multiple, randomized,controlled trials (RCTs) performed in the past 5 years that have demonstrated significant risk reduction from early allergen introduction. These include two trials for early peanut introduction and five trials for early egg introduction
in the first year of life. The results indicate that primary prevention of food allergy through early allergen introduction may represent a strategy that could potentially avert tens of thousands of children from becoming food allergic. In support of the data for peanut, the National Institute of Allergy and Infectious Diseases recently sponsored an addendum to the 2010 food allergy guidelines, specifically recommending peanut be introduced in both high- and standard-risk infants to reduce the risk of developing peanut allergy. To date, no formal recommendations have been made for egg, however. This review will focus on the
latest evidence supporting early introduction as a strategy to prevent food allergy, as well as on practical aspects for its successful implementation.
Curr Allergy Asthma Rep. 2017 Apr;17(4):26. doi: 10.1007/s11882-017-0692-3.
据估计，在美国大约有8%的儿童受食物过敏影响。食物过敏目前尚无法治疗或治愈，且在部分患者中，可能相当严重甚至威胁生命。尽管近期对潜在治疗方法的研究取得重要进展，已有2种食物靶向的免疫治疗产品进入III期临床试验阶段，但该领域最大的突破可能在于避免高危人群产生食物过敏的潜在预防性策略的提出。过去5年中多项随机对照试验（RCTs）均表明，早期过敏原接触可显著降低食物过敏风险，其中包括出生后第一年内开始的2项早期花生引入试验和5项早期鸡蛋引入试验。这些结果表明，通过早期接触过敏原进行食物过敏的初级预防，可能避免数以万计的儿童发生食物过敏。根据上述花生试验的结果，美国国家过敏与感染疾病协会最近在“2010年食品过敏指南”中添加了一则附录，特别推荐为高风险及一般风险的婴儿食物中加入花生，以降低他们形成花生过敏的风险，但对鸡蛋目前尚无正式推荐。本综述将聚焦支持早期接触作为预防食物过敏策略的最新研究以及其成功应用的实践性因素。
(复旦大学附属中山医院呼吸科 胡湘麟摘译 杨冬审校)
（Curr Allergy Asthma Rep. 2017 Apr;17(4):26. doi: 10.1007/s11882-017-0692-3.）
（Curr Allergy Asthma Rep. 2017 Apr;17(4):26. doi: 10.1007/s11882-017-0692-3.）
Primary Prevention of Food Allergy.
Greenhawt MJ, Fleischer DM.
Abstract
Food allergy is estimated to affect approximately 8% of children in the USA. This is a disease without any known treatment or cure and, for some, a disease that can be quite severe, even life-threatening. While recent advances in potential treatment have made remarkable strides, with two food-targeted immunotherapy products now in phase III trials, perhaps the biggest gains in the field have come in the advent of potential preventative strategies to avoid the development of food allergy in high-risk individuals. There have been multiple, randomized,controlled trials (RCTs) performed in the past 5 years that have demonstrated significant risk reduction from early allergen introduction. These include two trials for early peanut introduction and five trials for early egg introduction
in the first year of life. The results indicate that primary prevention of food allergy through early allergen introduction may represent a strategy that could potentially avert tens of thousands of children from becoming food allergic. In support of the data for peanut, the National Institute of Allergy and Infectious Diseases recently sponsored an addendum to the 2010 food allergy guidelines, specifically recommending peanut be introduced in both high- and standard-risk infants to reduce the risk of developing peanut allergy. To date, no formal recommendations have been made for egg, however. This review will focus on the
latest evidence supporting early introduction as a strategy to prevent food allergy, as well as on practical aspects for its successful implementation.
Curr Allergy Asthma Rep. 2017 Apr;17(4):26. doi: 10.1007/s11882-017-0692-3.
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