Abstract：
Tree nut allergy is a lifelong and potentially life-threatening condition. The standard of care is strictly avoiding the culprit nut and treating accidental reactions symptomatically. To evaluate potential therapeutic options for desensitizing patients with IgE-mediated tree nut allergy, we systematically searched three bibliographic databases for studies published until January 2024. We looked for active treatments of IgE-mediated allergy to tree nuts (walnut, hazelnut, pistachio, cashew, almond, pecan, macadamia nut, and brazil nut). We focused on allergen-specific immunotherapy (AIT) using oral (OIT), sublingual (SLIT), epicutaneous (EPIT), or subcutaneous (SCIT) delivery, or other disease-modifying treatments. We found 19 studies that met our criteria: 3 studies investigated sublingual immunotherapy, 5 studied oral immunotherapy to a single tree nut, and 6 used multi-food oral immunotherapy with or without omalizumab. The remaining studies investigated the effectiveness of monoclonal antibodies or IgE-immunoadsorption in multi-food allergic patients, including patients with tree nut allergy. The heterogeneity of the studies prevented pooling and meta-analysis. Oral immunotherapy, single or multi-nut, with or without omalizumab, was the most studied approach and appears effective in conferring protection from accidental exposures. Omalizumab monotherapy is the only approved alternative management for reducing allergic reactions that may occur with accidental exposure.
摘要：
树坚果过敏是一种终生且可能危及生命的疾病。护理标准是严格避免罪魁祸首和对症治疗意外反应。评估IgE介导的树坚果过敏脱敏患者的潜在治疗选择，我们系统地检索了3个书目数据库,查找2024年1月之前发表的研究.我们寻找IgE介导的对树坚果过敏的积极治疗方法(核桃，榛子,开心果,腰果,杏仁,山核桃,澳洲坚果,和巴西坚果）。我们专注于使用口服（OIT）的过敏原特异性免疫疗法（AIT），舌下(SLIT)，表皮（EPIT），或皮下(SCIT)输送，或其他疾病改善治疗。我们发现了19项符合我们标准的研究：3项研究调查了舌下免疫疗法，5研究了对单树坚果的口服免疫疗法，和6使用多食物口服免疫疗法，有或没有奥马珠单抗。其余研究调查了单克隆抗体或IgE免疫吸附在多食物过敏患者中的有效性，包括树坚果过敏的患者。研究的异质性阻碍了汇集和荟萃分析。口服免疫疗法,单螺母或多螺母，有或没有奥马珠单抗，是研究最多的方法，在保护意外暴露方面似乎很有效。Omalizumab单药治疗是唯一批准的替代治疗方法，用于减少意外暴露可能发生的过敏反应。
