食物过敏的一级、二级和三级预防:当前做法和未来方向。

IF 2.5 4区 医学 Q3 ALLERGY Allergologia et immunopathologia Pub Date : 2024-03-01 eCollection Date: 2024-01-01 DOI:10.15586/aei.v52i2.1023
Caoimhe Cronin, Noah Salzberg, Yuxin Woon, Juan Trujillo Wurttele
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引用次数: 0

摘要

食物过敏的发病率在全球范围内不断上升,专家们一直在探索预防幼儿食物过敏的方法,以减轻疾病负担,降低因食物过敏原引起的过敏性休克所导致的发病率和死亡率。这些预防措施可分为一级预防、二级预防和三级预防,本综述将对此进行详细讨论。一级预防是指防止对特定过敏原过敏。有证据表明,在孕期和母乳喂养期间避免食用常见的致敏食物并不能预防食物过敏,指南建议在婴儿 4 到 6 个月大时断奶,最近的研究支持在婴儿 4 个月大时尽早添加花生以预防花生过敏。二级预防针对的是已经过敏的患者,目的是阻止过敏的发展,有证据表明,在过敏婴儿中使用口服免疫疗法及早添加牛奶和花生的试验成功率高且安全。过敏三级预防的重点是降低患者发生过敏性休克的风险,口服免疫疗法是促进过敏儿童耐受性的最常用方法。有几项研究表明,重新引入牛奶、鸡蛋和花生的做法是成功的;但对于其他食物,目前还没有推荐此类指南。最后,以牛奶和鸡蛋阶梯为形式的饮食促进疗法已被用作过敏症的一级、二级和三级预防方法,尤其是在爱尔兰、英国和加拿大。
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Primary, secondary and tertiary prevention of food allergy: current practices and future directions.

The incidence of food allergies has risen around the globe, and experts have been exploring methods of preventing such allergies in young children to ease the burden of disease and reduce the morbidity and mortality caused by anaphylaxis to food allergens. Such preventative measures can be categorised as primary, secondary and tertiary prevention, which are discussed in detail in this review. Primary prevention is defined as the prevention of becoming sensitised towards specific allergens. The evidence suggests that avoiding common allergenic foods during pregnancy and breastfeeding is not protective against food allergies, and guidelines recommend weaning from 4 to 6 months of age, with recent studies supporting the early introduction of peanuts at 4 months to prevent peanut allergy. Secondary prevention targets patients who are already sensitised and aims to halt the progression of sensitisation, with evidence for high rates of success and safety in trials of early introduction to milk and peanuts using oral immunotherapy in sensitised infants. Tertiary allergy prevention focuses on reducing the risk of a patient having anaphylaxis, with oral immunotherapy being the most common method of promoting tolerance in allergic children. Several studies have demonstrated successful reintroduction for milk, egg and peanut; however, no such guidelines are recommended for other foods. Finally, dietary advancement therapy in the form of milk and egg ladders has been employed as a method of primary, secondary and tertiary prevention of allergies, particularly in Ireland, the UK and Canada.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: Founded in 1972 by Professor A. Oehling, Allergologia et Immunopathologia is a forum for those working in the field of pediatric asthma, allergy and immunology. Manuscripts related to clinical, epidemiological and experimental allergy and immunopathology related to childhood will be considered for publication. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) and also of the Latin American Society of Immunodeficiencies (LASID). It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" section. Letters to the Editor on previously published papers are welcomed. Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc.
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