Palabras clave
Prevención
Lactancia materna
Microbiota
Biológicos
Dermatitis atópica
Anafilaxia
Epinefrina
Resumen
lactancia materna exclusiva durante los primeros meses de vida, además de la suplementación con vitamina D y, debido a la importancia de la microbiota, adición de probióticos prebióticos y simbióticos. Actualmente la exposición tardía de los alimentos es controvertida, y se sugiere introducir tempranamente alimentos alergénicos, procurando no exponer la vía cutánea. La aplicación de biológicos en alergia alimentaria es un área de investigación y tratamiento en evolución. Los biológicos se indican en enfermedades evaluadas en diversos estudios, como la dermatitis atópica, y se encuentran aprobados por la FDA para su prescripción; sin embargo, aún se discute su potencial administración en el tratamiento de reacciones alérgicas graves provocadas por alimentos. Estas terapias pueden cambiar la forma en que se aborda la alergia alimentaria en el futuro, pero aún se encuentran en etapas experimentales y no están disponibles ampliamente. La anafilaxia por alimentos es una reacción alérgica potencialmente mortal, que requiere una acción rápida. La prevención implica evitar el alimento desencadenante, conocimiento de los síntomas y la disponibilidad de epinefrina para su administración inmediata en caso de alguna reacción.
Referencias
Prevención en alergia alimentaria
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Halken S, Muraro A et al.EAACI guideline: Preventing the development of food allergy in infants and young children. Pediatr Allergy Immunol 2021; 32 (5): 843-858.
Wang S Zuo Y Thymic Stromal Lymphopoietin in Cutaneous Immune-Mediated Diseases. Front Immunol 2021; 24: 698522.
Ralf GH. Food Allergy Prevention and Treatment by Targeted Nutrition. Nutr Metab 2018; 72: 33-45.
Ulfman L, Tsuang A, et al Relevance of Early Introduction of Cow's Milk Proteins for Prevention of Cow's Milk Allergy. Nutrients 2022; 14: 2659.
Di T, Chen L. A narrative review of vitamin D and food allergy in infants and children. Transl Pediatr 2021; 10: 2614-2620.
Renz H, Skevaki Ch. Early life microbial exposures and allergy risks: opportunities for prevention. Nat Rev Immunol 2021; 21: 177-191.
Probiotics, Prebiotics, and Synbiotics: Implications and Beneficial Effects against Irritable Bowel Syndrome. Nutrients 2021; 13: 2112.
Muraro A, Worm M, et al. European Academy of Allergy and Clinical Immunology, Food Allergy, Anaphylaxis Guidelines Group (2022). EAACI guidelines: Anaphylaxis (2021 update). Allergy 2022; 77: 357-377. https://doi.org/10.1111/all.15032.
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Skypala IJ. Food-Induced Anaphylaxis: Role of Hidden Allergens and Cofactors. Front Immunol 2019; 10. doi: 10.3389/fimmu.2019.00673.
Commins SP, Jerath MR, et al. Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat. Allergol Int 2016; 65: 16-20.
Ade J, Jeffery M, et al. Validation of the revised National Institute of Allergy and Infectious Disease / Food Allergy and Anaphylaxis Network diagnostic criteria in em. J Allergy Clin Immunol 2021; 147: AB240. doi: 10.1016/j.jaci.2020.12.021.
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Foong RX, Giovannini M, du Toit G. Food-dependent exercise-induced anaphylaxis. Curr Opin Allergy Clin Immunol 2019; 19 (3): 224-228.
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Uso de biológicos en Alergia Alimentaria
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Chinthrajah S, Cao S, et al. Phase 2a randomized, placebo-controlled study of anti-IL-33 in peanut allergy. JCI Insight 2019; 4 (22): e131347.
Stein ML, Collins MH, et al. Anti-IL-5 (mepolizumab) therapy for eosinophilic esophagitis. J Allergy Clin Immunol 2006; 118 (6): 1312-19.
Anafilaxia por alimentos
Muraro A, Worm M, Alviani A, et al. European Academy of Allergy and Clinical Immunology, Food Allergy, Anaphylaxis Guidelines Group (2022). EAACI guidelines: Anaphylaxis (2021 update). Allergy 2022; 77: 357-377. https://doi.org/10.1111/all.15032.
Cardona V, Chicato T, et al. Guía de actuación en anafilaxia 2022. Sociedad Española de Alergia e Inmunología Clínica. Rev Alergia Méx 2022; 66: 1-39. https://guiagalaxia.com.
Cardona V, Álvarez-Perea A, et al. Guía de Actuación en Anafilaxia en Latinoamérica. Galaxia-Latam. Rev Alergia Méx 2019; 66 (6): 1-39. https://doi.org/10.29262/ram.v66i6.588
Cardona V, Ansotegui I, et al. World Allergy Organization Anaphylaxis Guidance 2020. World Allergy Org J 2020; 13: 100472. doi:10.1016/j.waojou.2020.1004.
Skypala IJ. Food-Induced Anaphylaxis: Role of Hidden Allergens and Cofactors. Front Immunol 2019; 10. doi: 10.3389/fimmu.2019.00673.
Commins SP, Jerath MR, et al. Delayed anaphylaxis to alpha-gal, an oligosaccharide in mammalian meat. Allergol Int 2016; 65: 16-20.
Ad J, Jeffery M, et al. Validation of the revised National Institute of Allergy and Infectious Disease / Food Allergy and Anaphylaxis Network diagnostic criteria in em. J Allergy Clinical Immunol 2021; 147: AB240. doi: 10.1016/j.jaci.2020.12.021.
Parrish CP, Kim H. Food-Induced Anaphylaxis: an Update. Curr Allergy Asthma Rep 2018; 18. doi: 10.1007/s11882-018-0795-5.
Foong RX, Giovannini M, du Toit G. Food-dependent exercise-induced anaphylaxis. Curr Opin Allergy Clin Immunol 2019; 19 (3): 224-228.
Feldweg A. MFood-Dependent, Exercise-Induced Anaphylaxis: Diagnosis and Management in the Outpatient Setting. J Allergy Clin Immunol 2017; 5: 283-288. doi: 10.1016/j.jaip.2016.11.022.
Fleischer DM, Chan ES, et al. A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical. J Allergy Clin Immunol 2021; 9: 22-43.
Du Toit G, Tsakok T, et al. Prevention of food allergy. Allergy Clin Immunol 2016; 137: 998-1010.
De Silva D, Halken S, et al. Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials. Pediatr Allergy Immunol 2020; 31: 813-826.
Halken S, Muraro A, et al. EAACI guideline: Preventing the development of food allergy in infants and young children. Pediatr Allergy Immunol 2021: 32 (5): 843-858.
Si-Hang Wang, Ya-Gang Zuo. Thymic Stromal Lymphopoietin in Cutaneous Immune-Mediated Diseases. Front Immunol 2021; 24: 698522.
Ralf GH. Food Allergy Prevention and Treatment by Targeted Nutrition. Nutr Metab 2018; 72: 33-45.
Ulfman L, Tsuang A, et al.Relevance of Early Introduction of Cow's Milk Proteins for Prevention of Cow's Milk Allergy. Nutrients 2022; 14: 2659.
Tianwei Di, Lihua Chen A narrative review of vitamin D and food allergy in infants and children. Transl Pediatr 2021; 10: 2614-2620.
Renz H, Skevaki Ch. Early life microbial exposures and allergy risks: opportunities for prevention. Nat Rev Immunol 2021; 21: 177-191.
Probiotics, Prebiotics, and Synbiotics: Implications and Beneficial Effects against Irritable Bowel Syndrome. Nutrients 2021; 13: 2112.
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Derechos de autor 2023 Revista Alergia México