摘要
近年来,坚果过敏相关疾病的患病率呈不断升高的趋势,一旦患病,将对人类的生命安全构成一定的威胁。由于多种坚果过敏原之间可能存在交叉反应,因此,《过敏性疾病诊疗指南》提出,一旦患者被确诊为坚果过敏,应严格避免食用所有类型的坚果。目前,临床已知核桃和山核桃以及腰果和开心果均存在高度交叉反应,但尚不清楚在其他坚果中免疫球蛋白E(IgE)所介导的交叉反应程度,因此,最安全的方法是避免食用所有类型的坚果。现阶段,针对食物过敏的免疫疗法已取得了新进展,例如,可采用口服免疫疗法(OIT)、舌下免疫疗法(SLIT)和表皮免疫疗法(EPIT)治疗对牛奶、鸡蛋和花生过敏的患者。然而,目前关于对坚果过敏免疫疗法的研究较少,但有研究表明,当坚果过敏原存在时,动物模型以及过敏患者体内均会出现T细胞交叉反应,因此认为免疫疗法亦可以用来治疗坚果过敏患者。该研究回顾了流行病学、过敏原同源性以及坚果间交叉反应的相关文献,并对如何将现有的研究结果有效地用于临床治疗进行了探讨。
In recent years,the prevalence of nut allergy-related diseases has been increasing,which will pose a certain threat to human life safety.With possible crossreactions among multiple nut allergens,Guidelines for the Diagnosis and Treatment of Allergic Diseases suggest that all types of nuts should be strictly avoided once a patient is diagnosed with a nut allergy.Currently,walnuts and pecans are clinically known to have highly cross-reactions as well as cashew and pistachios,but it is unclear about the extent of immunoglobulin E(IgE)mediated cross-reactions in other nuts,therefore,the safest method is to avoid eating all types of nuts.At this stage,new progress has been made in immunotherapy against food allergies,for example,oral immunotherapy(OIT),sublingual immunotherapy(SLIT)and epidermal immunotherapy(EPIT)have been adopted in treating patients allergic to milk,eggs,and peanuts.However,there is little research on nut allergy immunotherapy at present,but some studies have shown that T cell cross-reaction can occur in animal models and in allergic patients when nut allergen exists,so it is believed that immunotherapy can also be used to treat patients with nut allergies.The article reviewed the relevant literature on epidemiology,allergen homology,and cross-reaction between nuts,and explored how existing findings can be effectively used for clinical treatment.
作者
闫永凤
Yan Yongfeng(Clinical Laboratory,Tianjin Beichen Hospital,Tianjin 300400,China)
出处
《医疗装备》
2022年第9期187-191,共5页
Medical Equipment
