Age and eczema severity, but not family history, are major risk factors for peanut allergy in infancy.
Age and eczema severity, but not family history, are major risk factors for peanut allergy in infancy.
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年龄和湿疹的严重程度，而不是家族史，是婴儿花生过敏的主要危险因素。
DOI：
10.1016/j.jaci.2020.11.033
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Togias A
中科院分区：
文献类型：
--
作者：
Keet C;Pistiner M;Plesa M;Szelag D;Shreffler W;Wood R;Dunlop J;Peng R;Dantzer J;Togias A
在早期花生引进前是否筛查高危人群存在争议。我们试图确定花生引入前的风险花生过敏（PA）的婴儿（1）中重度湿疹，（2）其他食物过敏（FA），和/或（3）花生过敏（FH）的一级亲属。4 - 11个月的婴儿，没有花生摄入史，测试，或反应，至少有一个上述风险因素接受花生皮肤点刺试验，并根据皮肤点刺试验风团大小，口服食物挑战或观察喂养。共有321例受试者完成了入组访视（中位年龄，7.2个月; 58%为男性）; 78例仅患有湿疹，11例仅患有FA，107例仅患有FH，125例有多种风险因素。总体而言，195例湿疹患者中有18%患有PA，59例FA患者中有19%患有PA，201例FH患者中有4%患有PA。在115名患有FH且无湿疹的患者中，只有1%患有PA。在湿疹患者中，（比值比[OR]，1.3; 95% CI，每月1.04-1.68），特应性皮炎评分较高（OR，1.19; 95% CI，1.06-1.34/5分），黑人（OR，5.79; 95% CI，1.92-17.4，与白色相比）或亚洲人种（OR，6.98; 95% CI，1.92-25.44）和疑似或诊断的其他FA（OR，3.98; 95% CI，1.62-9.80）与PA相关。PA常见于中重度湿疹的婴儿，而无湿疹的FH不是主要危险因素，这表明仅在有明显湿疹的婴儿中进行筛查。即使在生命的第一年内，在湿疹患者中，后期引入与PA的风险较高相关，支持尽早引入花生。
Whether to screen high-risk groups before early peanut introduction is controversial. We sought to determine the risk of peanut allergy (PA) before peanut introduction for infants with (1) moderate-severe eczema, (2) another food allergy (FA), and/or (3) a first-degree relative with peanut allergy (FH). Infants aged 4 to 11 months with no history of peanut ingestion, testing, or reaction and at least 1 of the above risk factors received peanut skin prick test and, depending on skin prick test wheal size, oral food challenge or observed feeding. A total of 321 subjects completed the enrollment visit (median age, 7.2 months; 58% males); 78 had eczema only, 11 FA only, 107 FH only, and 125 had multiple risk factors. Overall, 18% of 195 with eczema, 19% of 59 with FA, and 4% of 201 with FH had PA. Only 1% of 115 with FH and no eczema had PA. Among those with eczema, older age (odds ratio [OR],1.3; 95% CI, 1.04–1.68 per month), higher SCORing Atopic Dermatitis score (OR, 1.19; 95% CI, 1.06–1.34 per 5 points), black (OR, 5.79; 95% CI, 1.92–17.4 compared with white), or Asian race (OR, 6.98; 95% CI, 1.92–25.44) and suspected or diagnosed other FA (OR, 3.98; 95% CI, 1.62–9.80) were associated with PA. PA is common in infants with moderate-severe eczema, whereas FH without eczema is not a major risk factor, suggesting screening only in those with significant eczema. Even within the first year of life, introduction at later ages is associated with a higher risk of PA among those with eczema, supporting introduction of peanut as early as possible.
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DOI：
10.3390/ijerph10115364
发表时间：
2013-11-01
影响因子：
--
作者：
Koplin, Jennifer J.;Allen, Katrina J.;Dharmage, Shyamali C.
通讯作者：
Dharmage, Shyamali C.
影响因子：
3.6
作者：
Hong X;Tsai HJ;Wang X
通讯作者：
Wang X
影响因子：
14.2
作者：
Koplin, Jennifer J.;Peters, Rachel L.;Allen, Katrina J.
通讯作者：
Allen, Katrina J.
影响因子：
6.1
作者：
Lavine, E.;Clarke, A.;Ben-Shoshan, M.
通讯作者：
Ben-Shoshan, M.
影响因子：
8
作者：
Greer, Frank R.;Sicherer, Scott H.;Burks, A. Wesley
通讯作者：
Burks, A. Wesley