[Food desensitization].

Pedro Piraino Sosa, Giovanni Ojeda Soley
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Abstract

In recent times, the primary approach to treating food allergies involved strict avoidance of the triggering allergen. Many considered this approach as lacking true treatment, leaving patients vulnerable to even small amounts or hidden sources of the allergenic food. Desensitization or Oral Tolerance Induction (OTI) is a studied method aiming for a lasting tolerance to the allergen. The ultimate goal is permanent tolerance, where allergic reactions won't reoccur after new exposure to the triggering allergen, following a period of abstinence. The research mainly focuses on allergen-specific immunotherapy, covering three routes: oral, sublingual, and epicutaneous immunotherapy. Milk, egg, and peanuts are the extensively studied foods due to their prevalence in allergies. The oral route is favored for inducing tolerance because ingestion of a food antigen by a non-allergic individual triggers an active immune response without causing an allergic reaction. The paradigm has shifted from recommending avoidance to early consumption strategies to prevent allergies. The period from 4 to 6 months of age is considered immunologically sensitive, where children with risk factors show increased allergic sensitization risk. Implementing these recommendations, considering family and community preferences, may reduce the burden of food allergies and healthcare costs.

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[食物脱敏]
近代以来,治疗食物过敏的主要方法是严格避免诱发过敏的过敏原。许多人认为这种方法缺乏真正的治疗效果,即使是少量或隐蔽来源的过敏食物也会使患者易受影响。脱敏或口服耐受性诱导(OTI)是一种经过研究的方法,旨在使患者对过敏原产生持久的耐受性。最终目标是永久耐受,即在禁食一段时间后,再次接触引发过敏的过敏原时不会再发生过敏反应。研究主要集中于过敏原特异性免疫疗法,包括三种途径:口服、舌下和皮肤外免疫疗法。牛奶、鸡蛋和花生因其在过敏中的普遍性而被广泛研究。口服途径是诱导耐受的首选途径,因为非过敏体质的人摄入食物抗原会引发活跃的免疫反应,而不会引起过敏反应。预防过敏的模式已从建议避免食用转变为早期食用策略。4 到 6 个月大这一时期被认为是免疫敏感期,有危险因素的儿童在这一时期过敏致敏的风险会增加。考虑到家庭和社区的偏好,实施这些建议可以减轻食物过敏的负担,降低医疗成本。
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