Ngokuguquguquka ngokuphawulekayo, i-NIH ithi iintsana kufuneka zisebenzise iprotheni ye-peanut ngoku
Kuze kube ngo-2008, iingcali zazicebise ukuba abantwana abasengozini enkulu yokunyuka kwamanqabunga enqabileyo banqanda ukutya okuqulethwe ngamanqwanqwa kude kube neminyaka emithathu ubudala. Ukongezelela koko, oomama babantwana abanjalo banconywa ukuba bagweme iipuntshi ngexesha lokukhulelwa kunye nokuhlaselwa. Ezi ngcebiso zibonakala zinengqiqo. Emva kwakho konke, awufuni ukondla iprotheni ye-peanut kumntwana onokuthi aqhube phambili ekuhlakuleleni i-anaphylaxis esongela ubomi, isisombululo esinamandla esichaphazela iinkqubo ezininzi zegciwane kwaye unokuvala ngokukhawuleza ukuhamba kwindlela yokuhamba ngomoya ukuba ungaphathwa ngokukhawuleza.
Ekutshintshisweni ngokupheleleyo ngokusekelwe kuphando, ngo-2017 iingcali zancoma ukuba iintsana ezisengozini enkulu yokuphuhlisa i-peanut buter instead of food feed containing containing peanuts ezinyangeni ezine ukuya ezintandathu ubudala. Kubonakala ukuba, ukutyalwa komlomo kumanqwanqwa kula bantwana akubangakho ukusabela kokusongela ubomi, kodwa kunokuba kunqwenela umntwana ukuba atye. Ngamanye amagama, ngokutya imveliso yamanqatha ebusheni, iintsana ezisemngciphekweni omkhulu wokunyuka kwamanqatha azinyamezele .
Ngaphambi kokuba siqale, masenze amanqaku ambalwa acacile. Okokuqala, iintsana akufanele zondliwe iinqunci okanye i-bhotela yamanqatha, asemabini aphelisa izingozi, kwaye kunokutya ukutya ukutya okunomdla wokunyuselwa kwesikhunta, njengotyheji okanye i-peanut. Okwesibini, ngaphambi kokuba nayiphi na intsana inondle iimveliso zepayanut, kufuneka kuqala ukuba zilungiselele kwaye zikwazi ukutya ukutya okunzulu.
I-Peanut Allergies ekuphumeni
Kwinqaku le-2010 elipapashwe kwiNcwadi ye-Allergy kunye ne-Clinical immunology , abaphandi bafumene ukuba ukusabalalisa kwe-peanut yokungabikho kwamanye amazwe phakathi kwabantwana base-US kuye kwavela kusuka kwi-0.4 yeepesenti ngo-1997 ukuya kuma-1.4 ekhulwini ngo-2008, umfanekiso obonisa izigidi zezingane.
Ingqalelo, iifom ephakamileyo ezifanayo sele zibhalwe kutshanje kwamanye amazwe, kunye neCanada, i-United Kingdom kunye ne-Australia.
Kubonakala ukuba, ukunyuka kwandala ye-peanut yokungabikho kwamanye amazwe ayinanto enxulumene nokufumaneka kwamanqwanqwane, ahlale ehlala kwiminyaka engama-40 edlulileyo.
Ngokutsho kwabaphandi:
"Iingcamango malunga nesizathu sokwandisa izinga lokunyuka kwamanqatha ebantwini kubandakanya ukunyuka kwama-pegenut, i-peanut ye-peanut, ukuqala kokuqala kwesikhunjeni xa i-immune system isanda, ukufakwa kwexesha le-peanut ukulibaziseka, kunye nokungcoliswa kwendalo kwipapian ngaphandle kokungcola . "
Study LEAP
Iziphumo ezivela kwi-Learning Early malunga nePeanut Allergy (LEAP) Uphando olupapashwe kwi -New England Journal of Medicine ngo-2015 lwaguquka ukuqonda kwengqondo yobuncinane bentanethi kwintloko yayo.
Kulo vavanyo olungenamsebenzi, abaphandi babela abantwana abangama-640 abanesifo esibi kakhulu, i-egg allergies, okanye zombini-zonke izikhombisi zeengcambu zengozi yokungena emzimbeni-nokuba yiqela lokulinga , apho iintsana zondla iimveliso zepananut, okanye iqela lokulawula , apho abantwana bephephe i-peanut iimveliso ezide kwiinyanga ezingama-60 ubudala. Abaphandi bafumanisa ukuba ukuqaliswa kokuqala kweemveliso zesikhukhula kubantwana abasengozini enkulu yokunyuselwa kwamanqatha okunciphisa kakhulu ukuphuhliswa kobuchopho obunzima kunye nokulungelelanisa iimpendulo zokuzivikela kumzimba. Ngokukodwa, ukuqaliswa kwangaphambili kwamanqwanqwa kunciphise umngcipheko wokuhlakulela i-peanut ye-peanut nge-81%.
Ukuphefumlelwa kwalolu cwaningo luvela kuphando oludlulileyo olwenziwe ngabaphandi abonakalisa umngcipheko wokuphuhlisa i-peanut ye-peanut yexesha eliphindwe ngama-10 aphakamileyo phakathi kwabantwana abangamaYuda abahlala eUnited Kingdom kunokuba babengabantwana bakwa-Israyeli bazalwa ngokufanayo.
Uhlobo oluphambili phakathi kwala bantu babini lwaloo nto yabantwana abangamaYuda e-United Kingdom ngokuqhelekileyo abazange batye ii-peanuts ngunyaka wokuqala wokuphila; kanti, kwa-Israyeli, izilwanyana zaziswa ngokutya ngexesha leenyanga ezixhenxe.
I-Hypothesis ye-Double-Allergen Exposure Hypothesis
Isizathu sokuba kutheni abantwana abasebunciphekweni be-peanut-allergies abanamathuba amaninzi okuphuhlisa ukuxhatshazwa kwezilwanyana xa kutyalwa imveliso ye-peanut kusenokwenzeka ukuba kuyenzeka ngokubhekiselele kwi-hypothesis.
Okubalulekileyo, i-peanut allergens ingeniswa kwiintsana ezinobungozi kakhulu ngeendlela ezimbini. Okokuqala, ngenxa yokuba abo basengozini enkulu yokutya i-peanut bavame ukuba ne-eczema, okanye ukukhawuleza, iprotheni yepenanut evela kwimeko (umz., I-resian residu kwiitafile okanye i-oil peanut kwi-creams) inokwenza ikhefu liphule.
Okwesibini, iiprotheni zamaproteni zingadliwa ngumlomo.
Ukuba abantwana abasemngciphekweni ophezulu wokunqongophala kwamanqwanqwane bajoliswe ekuthintela ukusetyenziswa kwemveliso yamanqatha, yindlela kuphela yesikhukhula esenza igazi labo kukukhutshwa kwesikhumba. Ngokutsho kwe-double-allgengen hypothesis, le ndlela yokubhenca inokuthi ibenokubangela ukuphazamiseka kokuphazamiseka kunye nokuphuhliswa kwamanqatha. Ngakolunye uhlangothi, ukutyhila kwangaphambili komlomo kwiprotheni ye-peanut kubangela ukunyamezela.
Ngamanye amazwi, usana olusengozini oluphezulu lwe-peanut-allergies engenakondla iimveliso ze-peanut ekudleni kwakhe kusasazwa kwiprotheni ye-peanut kwindawo. Oku kubonakala kungakhokelela ekuthandeleni. Nangona kunjalo, ukuba uyayidla imveliso yamanqatha, uyaba neenjongo zokufumana izilwanyana kunye nokunyamezela.
Izikhokelo ezintathu
Ngenxa yeziphumo zoFundo lwe-LEAP kwakunye neengxaki malunga nokwanda kwamazinga okunyuka kwamanqatha, ngoJanuwari 2017, iphaneli yecandelo kunye nekomiti yokuququzelela edibaniswe yiSizwe soBuquzi bezilwanyana kunye nezifo ezithathelwanayo ezikhutshwe "i-peanut allerergy" isongezelelo Izikhokelo zika-2010 ekuqaleni zichaza iinkcukacha zokuxilongwa nokuphathwa kokutya kokutya. Esi sihlomelo sincoma izikhokelo ezintathu zesiklinikhi entsha .
Isikhokelo soku-1 sincoma ukuba ukuba umntwana unesifo esinzima kakhulu se-eczema, iqanda elingahambiyo okanye zombini-kwaye ngoko-ke kunomngcipheko ophezulu we-peanut-allergies-containing containing foods should be introducted in the diet as early four to six weeks of age. ekuphuhliseni i-peanut. Nceda uqaphele ukuba kubantwana abane-eczema enzima, ukuqaliswa kweprotheni yepenaniti kudinga igalelo kunye nesikhokelo somntwana wezilwanyana okanye enye ingcali.
Ngokukodwa, ugqirha uza kuqala ukwenza uvavanyo lokuxilongwa kwegazi okanye ubhekise umntwana kumntwana wezilwanyana onokwazi ukuhlola uvavanyo ukuze aqinisekise ukuba ukhusele umntwana ukuba adle iprotheni yepanethi kunye nendlela yokulondoloza ngokukhuselekileyo ukutya okunomdla yokutya. Okubaluleke kakhulu, ezinye iintsana ezisetyenziselwa ukutshatyalaliswa kwimiba enamandla xa zivivinywa (ivili elikhulu kakhulu), ukuba sele zineenkcenkceshe zokutya kwaye azikwazi ukunyamezela ukuqaliswa kwamanqwanqwa ekudleni ngaphandle komngcipheko we-anaphylaxis.
Isikhokelo sesi-2 sikhombisa ukuba ukuba umntwana usenokwakheka kwe-eczema engqameneyo, kufuneka ukutya okufakwe kwi-peanut kuqaliswe ekudleni kwinyanga engangeenyanga ezintandathu ukunciphisa umngcipheko wokuphuhlisa i-peanut. Nangona kunjalo, ukuqaliswa kwiprotheni ye-peanut kwisidlo seentsana ezine-eczema ephakathi kunye nomngcipheko omncinci wokuphuhlisa i-peanut-allergies ayikho imfuneko njengokuba umntwana wayenobungozi obukhulu kunye nomngcipheko ophezulu wokunyuselwa kwamanci.
Kwiintsana ezine-eczema ephakathi, ukungeniswa kokutya kwepayuteri akufuneki ukuba kuqhutywe-ngokukodwa ukuba ukutya okuqulethwe yi-peanut akuyiyo inxalenye yentsapho yokutya rhoqo. Njengoko kunye neentsana ezinobungozi obukhulu, ukuveliswa kweemveliso zepananut kwizidlo zabantwana abane-eczema esilinganisweni kungenziwa kuqala ekhaya okanye ngexesha lokunyusa kwiofisi yonyango ngokuxhomekeke kumgqirha kunye nokukhetha isigulane.
Ngokumalunga nezikhokelo 1 kunye no-2, nceda ugcine engqondweni ukuba ukuzimisela malunga nokuba isigulane se-eczema sinzima okanye sinobubele senziwa ngonyango.
Isikhokelo sesi-3 sikhombisa ukuba kubantwana abangenayo i-eczema okanye ukutya okungafunekiyo, iimveliso zepayanut ziqaliswa ngendlela efanelekileyo kunye kunye nezinye ukutya okuqinileyo kuxhomekeke kwindlela yokutya yentsapho kunye nezindlela zokutya.
Okukwintsusa
I-Peanut i-allergies ithatha inzuzo enkulu yengqondo kunye nezoqoqosho kwiintsapho ezingenakubalwa kuphela e-United States kodwa nakwihlabathi jikelele. Kwisininzi sabantu abanomdla wokutya, i-allergies iqala ngexesha lobuncinci kwaye iqhubeka iphila. Ukusabalalisa kwimiba yokunyuka kwamanqatha kwandiswe ngokukodwa ngexesha leminyaka edlulileyo.
Ngaphambi ko-2008, abantwana ababengumngcipheko ophezulu wokunqongophala kwamanqwane babekwacetyiswa ukuba bagweme ukutya okuqulethe i-peanut kunye neeprotheni ze-peanut. Nangona kunjalo, ngoku siyazi ukuba kwiintsana ezithile ezinobungozi obuphezulu bokunqongophala kwamanqatha, ukuqaliswa kwangaphambili kokutya kwesikhunta kwisitya kunokunyusa ukunyamezela. Iimpembelelo zezi ziphumo zizinzulu, kwaye, ngokuzayo, ukuqaliswa kwangaphambili kwiprotheni ye-peanut kwisidlo salabo abasemngciphekweni wokunyuselwa kwamanqwanqwa kunganciphisa ixabiso le-peanut.
Ukuba umntanakho akanalo i-peanut ye-peanut kodwa engengozini (cinga i-eczema, iqanda elithintekayo okanye zombini), yinto efanelekileyo ukudibana nodokotela wakho ukuxoxa ngokusungulwa kweprotheni ye-peanut ekudleni kwakhe.
> Imithombo:
> IziHlomelo zeziHlomelo zoLungiso lweePeanut e-United States: Isishwankathelo sabazali kunye nabanakekeli. https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-parent-summary.pdf
> Du Toit et al. Uvavanyo lweRangelised of Peanut Usetyenziso kwiintsana ezisengozini ye-Peanut Allergy. I-New England Journal of Medicine . 2015; 372: 9.
> Ukungabikho, G. njani Ukutya kwezilwanyana eziphuhlisayo? http://tna.europarchive.org/20120419000433/http://www.food.gov.uk/multimedia/pdfs/howdoesfoodallergydevelop.pdf
> U-Sicherer, SH et al. Ubuninzi be-US ye-peanut eyaziwayo, i-nut nut, kunye ne-sesame yokungasebenzi: ulandelelwano lweminyaka eli-11. I-Journal ye-allergies kunye ne-Clinic Immunology . 2010; 125: 6.
> Togia A et al. Isikhokelo soHlomelo sokuthintela i-peanut-allergies e-United States: INgxelo yeSizwe soBuquzi bezilwanyana kunye neNtsholongwane yezifo ezixhasayo. Ama-Annal of Allergy, i-Asthma & Immunology . 2016.