食物过敏与营养健康

随着食源过敏性疾病发病率的增加，食物过敏成为全球关注的公共卫生问题。食物过敏的高危人群为婴幼儿和儿童，是儿童继发性营养不良的原因之一。美国、澳大利亚、荷兰等发达国家在食物过敏发病率、过敏原、预防及干预措施等方面进行了大量的研究。本文就食物过敏的流行情况、过敏原、对营养健康的影响以及食物过敏的主要影响因素方面的最新研究进行综述。     

儿童过敏性鼻炎变应原检测分析

目的了解儿童过敏性鼻炎变应原分布情况,为预防和治疗儿童过敏性鼻炎提供依据。方法采用体外特异性过敏原检测试剂盒(IVT)对过敏性鼻炎患儿同时进行吸入性过敏原(IVT713)和食物性过敏原(IVT706)检测。利用回顾性方法分析256例过敏性鼻炎患儿变应原的分布情况及与患者年龄、伴随过敏性疾病、家族过敏史的关系。结果256例过敏性鼻炎患儿变应原检测总阳性率为83%。其中IVT713阳性率为71%,其中尘螨类最高51%,其次是花粉类19%。IVT706总阳性率为20%,其中以鱼类为最高。吸入性过敏原的阳性率与年龄、家族过敏史、病程及伴随过敏性疾病呈正相关。结论尘螨为儿童过敏性鼻炎主要过敏原,明确过敏原对过敏性鼻炎的预防、诊断及采取特异性免疫治疗具有重要的指导意义。     

儿童过敏的常见表现与防治

儿童是过敏性疾病的多发群体,且发病率逐年增高.过敏性疾病是指身体受到外来过敏原的刺激而引发的异常变态反应.据世界变态反应组织(WAO)调查显示,全球每年有约2.5亿人患过敏性疾病,其中儿童以湿疹、过敏性鼻炎、支气管哮喘最常见.如支气管哮喘在0～14岁儿童中患病率为1.56％,儿童过敏性鼻炎的患病率高达7.5％.过敏性疾病已成为影响儿童健康的重大公共卫生问题.过敏性疾病虽然一年四季均可发病,但以春秋季发病率最高,应特别重视加强防治.     

滚蛋吧!鼻炎

正过敏性鼻炎是一种常见的儿童过敏性疾病,表现为鼻塞、流清涕、鼻子痒、常常打喷嚏,也可以由于鼻后滴流导致慢性咳嗽。过敏性鼻炎的治疗除了遵医嘱外,家庭护理也不可小觑。过敏性鼻炎该避免的过敏原过敏性鼻炎常见的过敏原包括尘螨、宠物皮屑、花粉、霉菌等。在居家生活中,我们可以采用以下几种方法来帮助控制:     

义乌地区过敏性疾病患者血清过敏原检测及分析

目的了解义乌地区过敏性疾病的发病率及规律,探讨过敏原的检出率。方法采用免疫印迹法对5 914例患者进行血清过敏原检测,按照月份、年龄和重叠过敏进行分组并对结果统计分析。结果本地区过敏性疾病的发病率为28.37%,检出率为45.30%。吸入性过敏原的检出率为23.33%,检出率居前3位的是尘螨(16.89%)、蟑螂(1.59%)和普通豚草(0.83%);食物性过敏原的检出率为21.96%,检出率居前3位的是蟹(8.01%)、海鱼(6.17%)和淡水鱼(2.49%)。7月-9月为过敏性疾病的高发季节,≤10岁和11岁~20岁为易过敏人群,69.07%的患者对单一物质过敏。结论过敏性疾病在本地有一定的发病率,明确过敏原可对过敏性疾病的预防、病因诊断和临床脱敏治疗提供重要的指导意义。     

树花粉过敏原组分诊断策略：识别关键过敏原以制定治疗方案

全球树花粉致敏阳性率逐年增加, 严重影响过敏性疾病患者的生活质量。在华北和华中地区, 桦木花粉、柏树花粉和梧桐树花粉是春季花粉症患者中最为常见的过敏原。不同地理区域的植物分布和花粉传播规律导致了不同的花粉暴露结果, 从而进一步加大了对诊断和治疗个体化需求的挑战。本文通过深入解读欧洲过敏和临床免疫学会(EAACI)发布的《过敏原组分诊断指导建议2.0》中关于树花粉过敏的研究进展和临床应用, 探讨了PR-10蛋白、Profilins、Polcalin等树花粉的主要过敏原家族和组分蛋白, 以及可能导致花粉食物过敏综合征的交叉反应组分。通过过敏原组分诊断可以区分真正过敏患者和对多重过敏原的反应, 从而更有针对性地选择过敏原进行特异性免疫治疗, 提高治疗效果, 如Bet v 1和Cup a 1为桦树和柏树过敏患者免疫治疗的特异性指标。本文对该指南解读, 为树花粉过敏领域的专业人员提供前沿信息, 深入分析树花粉过敏原组分蛋白、临床表现和治疗的相关研究, 有助于更好地理解和应对树花粉过敏的挑战。     

南宁市0～24个月婴幼儿过敏性疾病的临床特征及相关影响因素分析

目的探讨南宁市0~24个月婴幼儿过敏性疾病的临床特征及相关影响因素。方法回顾性分析2014年10月-2017年4月在广西壮族自治区妇幼保健院体检的2600例婴幼儿资料,统计过敏性疾病婴幼儿临床特点,检测过敏原类型及占比,同时采用问卷调查筛查婴幼儿过敏性疾病的相关影响因素。结果研究中发现过敏性疾病的类型为过敏性哮喘(5.88%)、湿疹(3.19%)和皮疹(2.92%),过敏性疾病的发病率为9.08%(236/2 600),作为研究组,其中有3种过敏性疾病的患儿46例,2种过敏性疾病的患儿60例,1种过敏性疾病的患儿130例,无过敏性疾病的婴幼儿作为对照组(2 364例);过敏原阳性率为52.77%(1 372/2 600),居前3位的过敏原依次为尘螨(户尘螨、屋尘螨)807例(58.82%)、霉菌组合416例(30.32%)及猫狗毛皮屑257例(18.73%),其中1 024例(74.64%)患儿包括2种及以上过敏原;依次采用单因素和多因素Logistic回归分析法确定分娩方式、喂养方式、过敏性疾病史、居住环境、烟草暴露情况及妊娠期高血压疾病是婴幼儿过敏性疾病发生的独立危险因素。结论南宁市0~24个月婴幼儿过敏原主要为尘螨、霉菌组合及猫狗毛皮屑,过敏性疾病的发生与分娩方式、喂养方式、过敏性疾病史、居住环境、烟草暴露情况及妊娠期高血压疾病密切相关,控制危险因素,降低过敏性疾病的发生率,从而提高生活质量。     

198例新疆博州地区儿童过敏性疾病特异性过敏原IgE分析

随着城市工业化进程,空气、水质污染及环境卫生、居住条件、饮食习惯等发生改变,过敏性疾病的发病率逐年升高[1],但病因不明确,且病情易反复和迁延不愈,使预防及治疗存在困难.上世纪60年代以来,国内外先后开展过敏原特异性IgE抗体的体外实验诊断技术[2].大多数过敏性疾病首先要避免接触过敏原,故明确过敏原对疾病预防和治疗尤为重要;且不同地区过敏原成分有不同.新疆博尔塔拉蒙古自治州人民医院对该院198例过敏性疾病患儿开展了过敏原检查.     

过敏性疾病患儿过敏原特异性IgE检测分析

目的 分析儿童过敏性疾病患者过敏原分布特点,为IgE介导的过敏性疾病的临床诊治与预防提供资料。 方法 以2018年1—12月在湖南省妇幼保健院就诊的过敏性疾病患儿为检测对象,采用酶联免疫吸附试验,检测患儿血清过敏原特异性IgE抗体,IgE ≥0.35 IU/ml判断为阳性,应用SPSS 20.0软件分析过敏原阳性检出情况。 结果 共检测过敏性疾病患儿487例,过敏原特异性IgE抗体阳性检出率为64.07%(312/487)。在吸入性过敏原中前三位阳性率依次为尘螨(30.36%)、屋尘(23.41%)和花粉(19.10%)。食物性过敏原阳性率前三位依次为牛奶(20.74%)、蛋(11.91%)和鱼虾蟹贝(9.24%)。男、女儿童过敏原阳性率分别为67.03%与60.10%,性别差异无统计学意义(χ²=2.49,P<0.05)。尘螨、屋尘、花粉阳性率随患儿年龄增长而升高(均P<0.01),牛奶阳性率则随患儿年龄增长而降低(χ²=11.80,P<0.01)。同一病例检出2种及以上过敏原的病例数占总病例数的46.20%,检出3种及以上的过敏原占21.56%。 结论 儿童最重要的吸入性过敏原是尘螨,婴幼儿尤其是婴儿最重要的食物性过敏原为牛奶。近半数的过敏性疾病患儿被多种过敏原致敏。     

过敏季节话过敏

“过敏”一词始于希腊，原意为不正常的反应，也叫变态发应。过敏性疾病是指机体受过敏原，如花粉、粉尘、食物、药物、寄生虫等刺激后，引起的组织损伤或生理功能紊乱。现代科学发现，这种不正常的反应和免疫细胞中Th1／Th2失衡有关。     

Impacts of climate change on plant food allergens: a previously unrecognized threat to human health

Global climate change has had, and will continue to have, many significant impacts on biological and human systems. There are now many studies of climate change impacts on aeroallergens, particularly pollen, including a study demonstrating significant increases in the major allergen content of ragweed pollen as a function of rising atmospheric carbon dioxide concentration ([CO₂]). Recent research has also demonstrated more allergenic poison ivy in response to elevated [CO₂]. Here, we suggest, for the first time, the potential for global climate change, and, in particular, increased [CO₂] and temperature, to have an impact on the allergenicity of plant food allergens such as peanut. Such impacts could have significant impacts on associated allergic diseases, and pose a previously unrecognized threat to human health. There is an urgent need for research on the impacts of climate change on plant food allergens.     

Is the global rise of asthma an early impact of anthropogenic climate change?

The increase in asthma incidence, prevalence, and morbidity over recent decades presents a significant challenge to public health. Pollen is an important trigger of some types of asthma, and both pollen quantity and season depend on climatic and meteorologic variables. Over the same period as the global rise in asthma, there have been considerable increases in atmospheric carbon dioxide concentration and global average surface temperature. We hypothesize anthropogenic climate change as a plausible contributor to the rise in asthma. Greater concentrations of carbon dioxide and higher temperatures may increase pollen quantity and induce longer pollen seasons. Pollen allergenicity can also increase as a result of these changes in climate. Exposure in early life to a more allergenic environment may also provoke the development of other atopic conditions, such as eczema and allergic rhinitis. Although the etiology of asthma is complex, the recent global rise in asthma could be an early health effect of anthropogenic climate change.     

儿童变应性鼻炎发病影响因素分析

随着全球经济发展、环境破坏,以及人们生活方式、居住环境和饮食结构的改变促进了变态反应性疾病的发生发展,变应性鼻炎（allergic rhinitis,AR）逐渐成为影响人们生活的常见病、多发病,其发病率呈逐年增加,已成为被广泛关注的影响全球的健康问题.本文主要从儿童AR发病影响因素的研究成果进行综述.     

气候变化对儿童健康影响的研究进展

以全球变暖为主要特征的气候变化正成为世界关注的公共卫生问题。气候变化可以通过多种途径对人群健康造成危害,儿童由于其特有的生理代谢和行为认知特点,更容易受到气候变化的威胁。本文通过综述气候变化对儿童健康影响的研究现状,提出相应的适应和减缓措施,可为预防和控制气候变化相关伤害、疾病和死亡在儿童群体中的发生提供科学依据。     

An integrated assessment framework for climate change and infectious diseases

Many potential human health effects have been hypothesized to result either directly or indirectly from global climate change. Changes in the prevalence and spread of infectious diseases are some of the most widely cited potential effects of climate change, and could have significant consequences for human health as well as economic and societal impacts. These changes in disease incidence would be mediated through biologic, ecologic, sociologic, and epidemiologic processes that interact with each other and which may themselves be influenced by climate change. Although hypothesized infectious disease effects have been widely discussed, there have not yet been thorough quantitative studies addressing the many processes at work. In part this is because of the complexity of the many indirect and feedback interactions or mechanisms that bear on all aspects of the climate issue. It also results from the difficulty of including the multitude of always-changing determinants of these diseases. This paper proposes a framework for an integrated assessment of the impacts of climate change on infectious diseases. The framework allows identification of potentially important indirect interactions or mechanisms, identification of important research gaps, and a means of integrating targeted research from a variety of disciplines into an enhanced understanding of the whole system.     

气候变化对传染病发生的影响

气候因素对传染病的发生和流行产生重要影响.从病原体、媒介、传播途径和人体免疫力等方面直接或间接影响传染病的发病趋势.文章就气候变化对呼吸道传染病、肠道传染病、虫媒传染病和自然疫源性疾病的影响进行了概述,力求全面了解气候变化对传染病发生和传播的影响,为公共卫生部门制定科学防控措施提供依据.     

Climate change impacts and risks for animal health in Asia

The threat of climate change and global warming is now recognised worldwide and some alarming manifestations of change have occurred. The Asian continent, because of its size and diversity, may be affected significantly by the consequences of climate change, and its new status as a 'hub' of livestock production gives it an important role in mitigating possible impacts of climate variability on animal health. Animal health may be affected by climate change in four ways: heat-related diseases and stress, extreme weather events, adaptation of animal production systems to new environments, and emergence or re-emergence of infectious diseases, especially vector-borne diseases critically dependent on environmental and climatic conditions. To face these new menaces, the need for strong and efficient Veterinary Services is irrefutable, combined with good coordination of public health services, as many emerging human diseases are zoonoses. Asian developing countries have acute weaknesses in their Veterinary Services, which jeopardises the global surveillance network essential for early detection of hazards. Indeed, international cooperation within and outside Asia is vital to mitigating the risks of climate change to animal health in Asia.     

Geomatics and public health

Geomatics technology has tremendous potential to address public health issues particularly under the present circumstances of global climate change and climate or technology induced human migration, which result in an increase in the geographical extent and re-emergence of vector-borne diseases. The authors present an overview of the science of geomatics, describe the potential impacts of climate change on vector-borne diseases and review the applications of remote sensing for disease vector surveillance.     

感染性疾病流行现状、防控挑战与应对

近几十年来,尽管全球感染性疾病负担大幅度下降,但传统感染性疾病相关的发病和死亡仍不容忽视。另外,受全球气候变化、快速城市化和人口快速流动等多种因素影响,新发感染性疾病成为全球重要的公共卫生威胁。无论是全球还是我国,均面临传统和新发感染性疾病的双重威胁。新形势下的感染性疾病防控需加强全球合作,强调全社会跨学科、跨部门共同参与。     

Challenges to Protecting the Right to Health under the Climate Change Regime

Researchers and global policy makers are increasingly documenting negative health impacts from climate change, raising concerns for realizing the right to health. Importantly, courts have held that anthropogenic activities affecting climate may threaten a population’s standard of health and compromise its inviolable right to health. However, legal hurdles—such as the fragmentation of climate change and human rights laws and the difficulties in proving causal links—hamper efforts to litigate right to health claims in the context of climate change. To address these challenges, this article assesses the detrimental effects of climate change from an international human rights perspective and analyzes climate change litigation to explore potential avenues to press for the right to health in the face of climate change.