THE EFFICACY AND SAFETY OF ORAL IMMUNOTHERAPY FOR FOOD ALLERGIES IN PRESCHOOL-AGED CHILDREN

In the last two decades, food allergy (FA) has emerged as a significant concern, with a continuous rise in prevalence worldwide. Furthermore, increasing awareness about this issue in the general public has prompted rigorous efforts to find long-term solutions to FA. In the pediatric group, most cases of FA are reported during the initial 3 to 5 years. The most common FA in preschoolers include eggs, cows milk, tree nuts, and peanuts. Conventional approaches for the management of FA include mitigating adverse reactions associated with the consumption of food allergens and avoidance of that particular food allergen. However, constant avoidance remains a challenge, requiring constant due diligence. Therefore, Oral immunotherapy (OIT), an allergen-specific method for managing FA has been introduced. The present review provides an overview of the mechanisms and processes of OIT. The most common OITs studied include peanut, tree nuts, egg, and milk OITs. Furthermore, the literature search yielded significant evidence that showed the safety and efficacy of these OITs. The review also identified the gaps in the literature, which highlight the need for future investigations. Future studies should focus on conducting well-designed clinical trials with larger sample sizes, establishing standardized treatment protocols, investigating immunological mechanisms, and assessing the broader impact of OIT.近二十年来，食物过敏（food allergy, FA）已成为全球范围内备受重视的公共健康议题，其患病率呈持续上升趋势。与此同时，公众对该疾病的认知水平不断提高，推动学界展开大量研究以探寻食物过敏的长期解决方案。在儿科人群中，绝大多数食物过敏病例均报告于出生后的最初3至5年内。学龄前儿童最常见的致敏食物变应原包括鸡蛋、牛乳、坚果与花生。传统的食物过敏管理策略主要包括缓解食用致敏食物引发的不良反应，以及严格规避对应致敏食物。但长期坚持规避致敏食物仍颇具挑战，需要持续保持高度的谨慎与警惕。为此，口服免疫治疗（oral immunotherapy, OIT）——一种针对食物过敏的变应原特异性管理手段——被逐步应用于临床。本综述概述了口服免疫治疗的作用机制与实施流程。目前研究较为广泛的口服免疫治疗方案涵盖花生、坚果、鸡蛋及牛乳口服免疫治疗。此外，现有文献检索结果显示，此类口服免疫治疗方案具备良好的安全性与有效性。本综述同时指出了当前研究领域存在的空白，凸显了未来开展相关研究的必要性。未来的研究应聚焦于开展样本量更大、设计严谨的临床试验，建立标准化治疗方案，深入探究其免疫学机制，并评估口服免疫治疗的更广范围影响。