花粉食物综合征(PFS)是一种非常普遍的食物过敏,影响花粉致敏的儿童和成人。患者在食用生植物性食物时会出现过敏症状,由于这些食物中花粉过敏原和不稳定蛋白质之间的同源性。所涉及的触发因素可能因花粉致敏而有所不同,这反过来又受到地理位置的影响。英国过敏和临床免疫学协会(BSACI)护理标准委员会(SOCC)确定需要制定英国(UK)PFS诊断和管理指南。BSACI制定的指南使用GRADE或SIGN方法;由于缺乏高质量的证据,这些建议是使用SIGN指南制定的,这被认为不如等级方法健壮。PFS的正确诊断确保避免原发性花生或树坚果过敏的误诊或与另一种植物食物过敏对非特异性脂质转移蛋白的混淆。所涉及的特色食物,和快速发作的口咽症状,平均PFS通常可以仅从临床病史中诊断。然而,涉及树坚果的反应,花生和豆浆或对水果和蔬菜的严重/非典型反应可能需要额外的诊断测试。管理是通过排除已知的触发食品,这可能看起来很简单,但如果再加上预先存在的食物过敏或素食/纯素饮食的个人,这是非常有问题的。对花粉的免疫疗法不是PFS的有效治疗方法,尽管对食物进行口服或舌下免疫疗法似乎更有希望,大,需要对照研究。PFS的典型轻度症状可能导致错误的看法,即这种情况总是很容易管理,但是可能会发生严重的反应,对新食物出现症状的焦虑会对生活质量产生深远的影响。
Pollen food syndrome (PFS) is a highly prevalent food allergy affecting pollen-sensitized children and adults. Sufferers experience allergic symptoms when consuming raw plant foods, due to the homology between the pollen allergens and unstable proteins in these foods. The triggers involved can vary depending on the pollen sensitization, which in turn is affected by geographical location. The British Society of Allergy and Clinical Immunology (BSACI) Standards of Care Committee (SOCC) identified a need to develop a
guideline for the diagnosis and management of PFS in the United Kingdom (UK).
Guidelines produced by the BSACI use either the GRADE or SIGN methodology; due to a lack of high-quality evidence these recommendations were formulated using the SIGN
guidelines, which is acknowledged to be less robust than the GRADE approach. The correct diagnosis of PFS ensures the avoidance of a misdiagnosis of a primary peanut or tree nut allergy or confusion with another plant food allergy to non-specific lipid transfer proteins. The characteristic foods involved, and rapid-onset oropharyngeal symptoms, mean PFS can often be diagnosed from the clinical history alone. However, reactions involving tree nuts, peanuts and soya milk or severe/atypical reactions to fruits and vegetables may require additional diagnostic tests. Management is through the exclusion of known trigger foods, which may appear to be simple, but is highly problematic if coupled with a pre-existing food allergy or for individuals following a vegetarian/vegan diet. Immunotherapy to pollens is not an effective treatment for PFS, and although oral or sublingual immunotherapy to foods seems more promising, large, controlled studies are needed. The typically mild symptoms of PFS can lead to an erroneous perception that this condition is always easily managed, but severe reactions can occur, and anxiety about the onset of symptoms to new foods can have a profound effect on quality of life.