FOOD ALLERGY IN ADULTS AND ADOLESCENTS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 儿童早期食物过敏的自然历史在很大程度上仍未确定。先前的研究表明，绝大多数人在婴儿期和幼儿期患上食物过敏，到学龄时大部分过敏症状都会消失。然而，临床观察表明，可能有越来越多的儿童在成长过程中未能摆脱过敏，或者在青春期或成年后获得了新的敏感性。此外，对食物过敏的青少年和年轻人似乎有更严重的危及生命的反应，原因尚不清楚。在临床实践中，成年人的食物过敏通常被认为是一种终生疾病，建议患者无限期地严格避免。几乎没有正式的证据来指导这些做法，儿科Rast截止水平对青少年和成人的适用性尚未得到证实。我们假设，在儿童时期患有持续性食物过敏的人和在晚年获得过敏的人在临床和免疫学上与那些在学龄前不再对食物过敏的人是有区别的。为了验证这一假设，我们建议建立一组患有食物过敏的青少年和成年人，并通过临床病史、RAST测量、皮肤测试以及当临床指示时口腔食物挑战来表征这些个体。具体地说，我们将解决RAST测量在青少年和成人中与年幼儿童相比的预测价值。此外，我们将评估疾病持续性和严重性的潜在预测因素，如特定表位识别模式和细胞介体释放能力。我们将重点关注花生、牛奶、鸡蛋、大豆、坚果和贝类过敏，这些都是儿童和成人最常见的食物过敏。我们的长期目标是描述青春期和成年期食物过敏的自然历史，以便在这一相对未被研究的人群中开发更有效的疾病管理和确定潜在的治疗靶点。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The natural history of food allergy after early childhood remains largely undefined. Prior studies have suggested that the great majority of individuals acquire food allergy in infancy and early childhood and outgrow most of these allergies by school-age. Clinical observation, however, suggests that there may be an increasing number of children who fail to outgrow their allergies or who acquire new sensitivities in adolescence or adulthood. Furthermore, food-allergic adolescents and young adults appear to have more severe, life-threatening reactions for reasons that have yet to be elucidated. In clinical practice, food allergy in adults is generally presumed to be a lifelong condition, and patients are advised to practice strict avoidance indefinitely. There is little formal evidence to guide these practices, and the applicability of pediatric RAST cutoff levels to adolescents and adults has yet to be confirmed. We hypothesize that individuals with persistent childhood food allergy and individuals who acquire allergy in later years are clinically and immunologically distinguishable from those who outgrow food allergy by school-age. To test this hypothesis, we propose establishing a cohort of adolescents and adults with food allergy and characterizing these individuals by clinical history, RAST measurements, skin tests, and when clinically indicated, oral food challenges. Specifically, we will address the predictive value of RAST measurements in adolescents and adults in comparison to younger children. In addition, we will evaluate potential predictors of disease persistence and severity, such as specific epitope recognition patterns and cell mediator releasability. We will focus on peanut, milk, egg, soy, tree nuts, and shellfish allergy, some of the most common food allergies in both children and adults. Our long-term goal is to characterize the natural history of food allergy in adolescence and adulthood for the purpose of developing more effective disease management and identifying potential therapeutic targets in this relatively unstudied population.