9 解密花生過敏： 新療法與 預防措施 where peanut is frequently fed to infants in large quantities as snacks, when compared to the UK [6]. This prompted the National Health Service (NHS) of the UK to recommend introducing crushed or ground peanuts, or peanut butter to infants from the age of six months, after the infant is ready to ingest solid foods [7, 8]. The breakthroughs in the study of peanut allergy also came with the development of Palforzia, a novel drug for young patients already diagnosed with peanut allergy. Targeting patients aged from four to 17 years old, this drug was approved by the US Food and Drug Administration (FDA) in January 2020 [9]. It contains peanut allergens in powder form which can be ingested with a soft food [10]. By gradually escalating the dose until a limit is found, the patient can build up tolerance to small amounts of peanut protein. After the up-dosing stage, the patient will need to take a maintenance dose every day for the treatment to remain effective. This fact, combined with the high cost and the requirement of biweekly visits to doctors in the first six months of the treatment discouraged the widespread use by patients, especially during the pandemic shortly after its launch. These limitations eventually led to Palforzia’s flop in sales – showing us how a medical breakthrough does not necessarily lead to a successful business [10, 11]! The study of peanut allergy highlights the tentative nature of science – scientific theories are subject to change when new evidence arises. Therefore, it is crucial to be open-minded and keep abreast of the latest developments in scientific research. Before you share this article to those with peanut allergy, please 你試過突然想吃熱烘烘的花生醬煉乳多士嗎？ 雖然我們大多數人都會有共鳴，但花生過敏是最常見的 食物過敏之一。它通常從幼兒期開始出現，過敏情況在約八 成患者中會持續終生 [1, 2]。在嚴重個案中，即使攝入微量 花生也能導致危及生命的症狀，然而花生的蹤影在日常膳食 中可謂無處不在，使過敏者難以完全避免攝入花生。在過去， 花生過敏的「治療方法」僅限於避免進食花生，但近年研究 提出了預防和減輕這種常見過敏的方法。讓我們深入了解， 並嘗試破解花生過敏的難題吧！ 2015年，《新英格蘭醫學雜誌》（New England Journal of Medicine）發表了突破性的臨床試驗結果，指出 在高風險嬰兒的膳食中加入花生有助預防花生過敏 [3]。當 中原理稱為「脫敏法」（desensitization）：透過讓嬰兒攝取 分量逐漸增加的花生抗原（花生的致敏成分），從而提高身 體對花生的接受程度。這種被稱為「口服免疫療法」的脫敏 治療能引導嬰兒發展中的免疫系統，使其將花生識別為可信 賴的安全食物而非外來威脅。 2017 年 5月，在考慮到最新證據後，美國國家過敏及傳 染病研究所（United States National Institute of Allergy and Infectious Diseases / NIAID）建議在高風險嬰兒（四 至六個月大患有嚴重濕疹或（及）雞蛋過敏）的膳食中引入 花生 [4]，但此前應先進行初步免疫學測驗，以策安全並找 出處方花生的最佳方法。儘管如此，研究所對已確診花生過 敏兒的建議仍然是避免攝取花生。 By Roshni Printer make sure they understand that any attempt on the new therapeutic strategies should be closely supervised by medical professionals.
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