花粉-食物过敏综合征研究进展

Research progress on pollen food allergy syndrome

花粉-食物过敏综合征(pollen food allergy syndrome,PFAS)是花粉过敏者摄入含有交叉致敏组分的植物来源食物时引发的IgE介导过敏反应,在花粉过敏人群中广泛存在,儿童、成人均可出现。PFAS的症状通常局限于口咽部,在口腔接触食物数分钟内出现,因此也称口腔过敏综合征(oral allergy syndrome,OAS);少数PFAS患者会出现全身症状甚至严重过敏反应。目前PFAS的临床诊断主要依靠病史及致敏证据[皮肤点刺试验和(或)血清特异性IgE检测],口服激发试验可用于确诊不典型患者,而过敏原组分诊断是进一步精准诊治的基础。PFAS的治疗与管理目前仍以生活方式调整和对症药物治疗为主,过敏原特异性免疫治疗的效果和获益人群尚不确切。本文旨在综述PFAS在流行病学、发病机制及临床诊治方面的研究进展,以期增进临床医师对本病的认识,促进诊治进步。

Pollen food allergy syndrome(PFAS)is an IgE-mediated allergic reaction that occurs when some pollinosis patients ingest certain plant-derived food that contains cross-reactive allergenic components.PFAS is prevalent in both children and adult pollinosis patients.In most cases,PFAS symptoms are confined to the oropharynx and occur within several minutes after oral contact with food.Therefore,PFAS has been also referred as oral allergy syndrome(OAS).A small proportion of PFAS patients would experience systemic symptoms or anaphylaxis.Currently,the diagnosis of PFAS is mainly based on clinical history and allergic tests[skin prick tests and(or)serum specific IgE tests].Oral provocation tests are used to verify atypical patients.Component-resolved diagnosis is essential for further precise diagnosis and treatment.Management options for PFAS include lifestyle adjustment,symptomatic medication,and immunotherapy.The efficacy and appropriate population for immunotherapy need further investigation.This article aims to update the knowledge on epidemiology,pathogenesis and clinical management of PFAS,thereby enhancing clinicians′understanding as well as treatment progress of this disease entity.