Ekushintsheni okuphawulekayo, i-NIH ithi izingane kufanele zisuse amaprotheni
Kuze kube ngu-2008, ochwepheshe babeke batusa ukuthi izingane ezisengozini enkulu yokudla imithi ye-peanut ingcono kakhulu ukugwema ukudla okuqukethe amantongomane kuze kube yilapho okungenani iminyaka emithathu ubudala. Ngaphezu kwalokho, omama bezingane ezinjalo banconywa ukuba bagweme amantongomane ngesikhathi sokukhulelwa nokulahlwa. Lezi zincomo zibonakala zinengqondo. Phela, awufuni ukondla amaprotheni emanzini angakwazi ukuqhubeka nokuhlakulela i-anaphylaxis esongela impilo, isifo esibi kakhulu esithinta ama-organ systems futhi singavimba ngokushesha uma kungenakekelwa ngokushesha.
Ekuguqulweni okuphelele okusekelwe ocwaningweni, ochwepheshe base-2017 batusa ukuthi izinsana zisengozini enkulu yokuthuthukisa ukungezwani kwe-peanut kunokuba zondliwe ukudla okuqukethe amantongomane cishe ezinyangeni ezine kuya kweziyisithupha ubudala. Ngokusobala, ukwehliswa ngomlomo emanzini kulezi zingane akusho ukuphendula okusongela ukuphila, kodwa kunalokho kususa ingane ukuba ikhumbule. Ngamanye amazwi, ngokudla imikhiqizo ye-peanut esemncane, izinsana ezisengozini enkulu yokuphuza umquba we-peanut zibekezela .
Ngaphambi kokuba siqale, ake senze amaphuzu ambalwa acacile. Okokuqala, izinsana akufanele zondliwe wonke amantongomane noma ibhotela le-peanut lonke, okubili kokukhipha izingozi, futhi kunalokho kudliwa ukudla okuqukethe i-peanut, njengombhotela wamanzi we-peanut noma ama-peanut puffs. Okwesibili, ngaphambi kokuba noma yikuphi usana olunikezwa imikhiqizo ye-peanut, kumele kuqala ukuthi ulungele ukuthuthuka futhi akwazi ukudla ukudla okuqinile.
I-Peanut Allergies ekukhuphukeni
Ku-athikili ka-2010 eyanyatheliswa kuyi -Journal of Allergy and Clinical Immunology , abacwaningi bathola ukuthi ukusabalala kwezingane eziphakathi kwe-peanut kwande kusuka ku-0.4% ngonyaka ka-1997 kuya kuma-1.4% ngo-2008, isibalo esimele izigidi zezingane.
Ngokuphawula, ama-high frequencies afanayo asanda kubhalwa kwamanye amazwe, futhi, kufaka phakathi iCanada, i-United Kingdom ne-Australia.
Ngokusobala, ukukhula okwenyuka kwezilwane zasolwandle akusho lutho ngokutholakala kwamanci, okuye kwahlala njalo phakathi neminyaka engu-40 edlule.
Ngokusho kwabacwaningi:
"Ukucabanga ngokuthi isizathu sokwanda kwama-peanut amantombazane ezinganeni kubandakanya ukunyuka kwamazinga okugcoba kwama-peanut, ukusungulwa kokuqala kwepayutane lapho isimiso somzimba sokuzivikela sisanda, ukufakwa kokubambezeleka kwe-peanut ekudleni, nokuchayeka kwemvelo kwesikhuni ngaphandle kokungenisa . "
Isifundo se-LEAP
Imiphumela evela Ekufundeni Ngokuqala mayelana ne-Peanut Allergy (LEAP) Isifundo esanyatheliswe ku -New England Journal of Medicine ngonyaka ka-2015 saphendule ukuqondisisa kobuchwepheshe bokunciphisa ubuthongo obuncane ekhanda.
Kulesi sivivinyo esingenangqondo, abacwaningi babela abantwana abangu-640 abane-eczema enzima, ama-egg allergies, noma kokubili-zonke izinkomba zengozi ye-peanut yokungena emzimbeni-noma yiqembu lokuhlola , lapho izinsana zondliwa khona imikhiqizo ye-peanut, noma iqembu elilawulayo , lapho izingane zigwema khona i-peanut imikhiqizo kuze kube yizinyanga ezingu-60 ubudala. Abacwaningi bathola ukuthi ukusungulwa kokuqala kwemikhiqizo ye-peanut ezinganeni ezazisengozini enkulu yokuphuza uketshezi lwe-peanut kunciphisa kakhulu ukuthuthukiswa kokungezwani komzimba kanye nokwenza izimpendulo zamasosha omzimba zibe nezimpande. Ngokuqondile, ukwethulwa kokuqala kwamanoni kunciphisa ingozi yokukhula kwe-peanut kamuva ngamaphesenti angu-81.
Ukuphefumulelwa kwalolu cwaningo kwavela ekucwaningeni kwangaphambilini okwenziwe abacwaningi ababonisa ukuthi ingozi yokuthuthukisa ukungezwani kwamapulangwe kwakunezikhathi eziyi-10 eziphakeme phakathi kwezingane ezingamaJuda ezihlala e-United Kingdom kunokuba ziphakathi kwabantwana bakwa-Israyeli abanamakhosi afanayo.
Umehluko omkhulu phakathi kwalaba bantu ababili kwaba ukuthi amaJuda angamaJuda e-United Kingdom ngokuvamile awazange adle amantongomane ngonyaka wokuqala wokuphila; kanti, kwa-Israyeli, ama-peanuts ayethulwa ekudleni ezinyangeni eziyisikhombisa ubudala.
I-Hypothesis ye-Dual-Allergen Exposure Hypothesis
Isizathu sokuthi izinsana ezisengozini enkulu yokuncelisa i-peanut cishe zingenakukwazi ukuthuthukisa ukungezwani komzimba uma kudla imikhiqizo ye-peanut cishe ukuthi ihlobene kanjani ne-two-hyperhesis exposure hypothesis.
Ngokuyinhloko, izilonda ze-peanut zingafakwa ezinganeni ezinobungozi obukhulu ngezindlela ezimbili. Okokuqala, ngoba labo abasengozini enkulu yokuphuza i-peanut bavame ukuba nesifo se-eczema, noma ukuqhuma, amaprotheni avela emvelweni (isb., Izinsalela zama-peanut ematafuleni noma ngamafutha okupuni).
Okwesibili, amaprotheni angama-peanut angadliwa ngomlomo.
Uma izingane ezisengozini enkulu yokuncelisa i-peanut ziqondiswe ekugwemeni ukusetshenziswa kwemikhiqizo ye-peanut, indlela kuphela yesikhukhula esangena egazini yilapho ukukhishwa kwesikhumba. Ngokusho kwe-double-allergen exposure hypothesis, lo mzila wokungcola kungenzeka ukuthi ubangele ukugqugquzela ukwelapha kanye nokuthuthukiswa kokunciphisa umzimba. Ngakolunye uhlangothi, ukutholakala komlomo kwamaprotheni okuqala ngomlomo kubangela ukubekezela.
Ngamanye amazwi, usana olusengozini enkulu yokuphuza uketshezi lwe-peanut olungakondliwe imikhiqizo ye-peanut ekudleni kwakhe namanje kuvezwe amaprotheni emanzini emvelo. Lokhu kutholakala kungabangela ukungezwani. Kodwa-ke, uma ethengiswa imikhiqizo ye-peanut, uyangena emakhakheni futhi kube nokubekezela.
Iziqondiso ezintathu
Ngokubheka imiphumela yeSifundo se-LEAP kanye nokukhathazeka mayelana namazinga akhula we-peanut ukungezwani komzimba, ngoJanuwari 2017, iphaneli lobuchwepheshe kanye nekomidi lokuxhumanisa elihlanganiswe yiNational Institute of Ebola and Infectious Diseases lanikeze isithasiselo "sokunakekelwa kwekhanda" Imikhombandlela ka-2010 ekuqaleni ichaza ukuxilongwa nokuphathwa kokudla kokudla. Lesi sengezo sihlongoza imihlahlandlela emisha yomtholampilo emisha emisha .
Isiqondiso 1 sincoma ukuthi uma usana lune-eczema olunzima, iqanda lokungabi namagciwane noma kokubili-futhi ngaleyo ndlela lisesengozini ephakeme yokudla okuphefumulayo-okumele kube nokudla kwe-peanut kufanele kuhanjiswe ekudleni kungakapheli amasonto amane kuya kweyisithupha ubudala ukunciphisa ingozi yokuthuthukisa ukunyuka kwamapayut. Sicela uqaphele ukuthi ezinganeni ezine-eczema enzima, ukwethulwa kwamaprotheni omuncuba kudinga okokufaka kanye nokuqondiswa kwesidokotela sesazi noma omunye ochwepheshe.
Ngokucacile, udokotela uzoqala ukuhlola ukuhlolwa kwegazi noma abuyele ingane kumuntu ohlinzeka ngesifo sofuba ongakwazi ukuhlola ukuhlolwa kwesikhumba ukuze anqume ukuthi kuphephile yini ukuthi usana ludle amaprotheni we-peanut kanye nendlela yokulondoloza ngokuphepha ukudla okuqukethe i-peanut ukudla. Okubaluleke kakhulu, ezinye izinsana ezisetshenziselwa amantongomane zihlakulela ukusabela okunzima kakhulu lapho kuhlolwa (amasondo amakhulu kakhulu esikhumba) okusobala ukuthi kakade banomdlavuza we-peanut futhi abakwazi ukubekezelela ukwethulwa kwamanqamu ekudleni ngaphandle kwengozi ye-anaphylaxis.
Isiqondiso 2 sikhombisa ukuthi uma usana luba ne-eczema esilinganiselwe, ukudla okuqukethe i-peanut kufanele kuhanjiswe ekudleni ezinyangeni ezinyanga eziyisithupha ukunciphisa ingozi yokuthuthukisa ukungezwani kwamapayipi. Kodwa-ke, ukungeniswa kwamaprotheni ezinkukhunjini ekudleni kwezinsana ezine-eczema esilinganisako kanye nengozi ephansi yokuthuthukisa ukungezwani kwe-peanut akuyona into edingekayo njengokungathi ingane kufanele ibe ne-eczema enzima kanye nengozi ephezulu yokunakekelwa kwe-peanut.
Ezinganeni ezine-eczema esilinganiselwe, ukungeniswa kokudla kwe-peanut akudingeki ukuthi kugijimele-ikakhulukazi uma ukudla okuqukethe i-peanut akuyona ingxenye yokudla komndeni njalo. Njengezinsana ezine-eczema enkulu, ukwethulwa kwemikhiqizo ye-peanut ekudleni kwezingane ezine-eczema esilinganisweni kungenziwa kuqala ekhaya noma ngesikhathi sokudla ehhovisi likadokotela kuye ngokuthi udokotela nodokotela abathandayo.
Ngokuphathelene neziKhombandlela 1 no-2, sicela ugcine engqondweni ukuthi ukuzimisela ukuthi i-eczema yesineke ikhulu noma inomusa eyenziwa umtholampilo.
Umhlahlandlela wesi-3 ukhombisa ukuthi ezinganeni ezingenayo i-eczema noma ukungezwani kokudla, imikhiqizo equkethe i-peanut isethulwa ngendlela ehambisana nesikhathi esifanayo futhi kanye nezinye ukudla okuqinile ngokuya kwemikhuba yokudla yomndeni kanye nemizila.
Ngaphansi
Ukwelashwa kwe-Peanut kuthatha umonakalo omkhulu wezepolitiki nezomnotho emindenini engenakubalwa kuphela e-United States kodwa nasemhlabeni jikelele. Iningi labantu abanomdlavuza we-peanut, ukungezwani komzimba kuqala ngesikhathi seyingane futhi kuphikelela kulo lonke impilo. Ukusabalala kwezidakamizwa ze-peanut kuye kwanda kakhulu phakathi neminyaka embalwa eyedlule.
Ngaphambi kuka-2008, izingane ezazisengozini enkulu yokuthola usizo lwezinkukhu zaxwayiswa ukuba zigweme ukudla okuqukethe amaprotheni nama-protein asepayini. Kodwa-ke, manje siyazi ukuthi kwezinye izinsana ezinengozini ephakeme yokwelapha i-peanut, ukusungulwa kokuqala kokudla kwe-peanut ekudleni kungaba empeleni kwakha ukubekezelelana. Okubalulekile kwalokhu kutholakala kuyinkimbinkimbi, futhi esikhathini esizayo, ukusungulwa kokuqala kwamaprotheni e-peanut ekudleni kwalabo abasengozini yokuguqulwa kwamanoni kunganciphisa izinga lokunciphisa umzimba.
Uma ingane yakho ingenayo i-peanut yokungezwani komzimba kodwa isengozini yayo (cabanga nge-eczema, iqanda lokungalingani noma kokubili), kuwumqondo omuhle ukuhlangana nodokotela wakho ukuxoxa ngokusungulwa kweprotheni yamaprotheni ekudleni kwakhe.
> Imithombo:
> Izinkombandlela Zezengezo Zokuvimbela I-Peanut Yokungezwani Komzimba e-United States: Isifinyezo sabazali nabanakekeli. https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-parent-summary.pdf
> Du Toit et al. Ukulingwa Okungahleliwe Kwe-Peanut Ukusetshenziswa Kwezingane Ezengozini Yokudla Kwezinhlanzi Ze-Peanut. I-New England Journal of Medicine . 2015; 372: 9.
> Ungekho, G. Ukudla Kwezifo Zokudla Kwenziwe Kanjani? http://tna.europarchive.org/20120419000433/http://www.food.gov.uk/multimedia/pdfs/howdoesfoodallergydevelop.pdf
> Isitifiketi, SH et al. Ukusabalala kwe-US kwe-peanut okubikwayo, i-nut nut, ne-sesame yokungezwani komzimba: ukulandelela kweminyaka engu-11. I-Journal Yokuzifola Kwegazi Ne-Immunology Yezokwelapha . 2010; 125: 6.
> Togia A et al. Imihlahlandlela yokwengeza yokuvimbela ukungezwani kwamapayipi e-United States: Umbiko we-National Institute ofergy and Infectious Diseases panel-expert sponsored panel. Ama-Annal ofergy, i-Asthma & Immunology . 2016.