Reducing the need for food allergen challenges in young children:: a comparison of in vitro with in vivo tests
Reducing the need for food allergen challenges in young children:: a comparison of in vitro with in vivo tests
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DOI：
10.1046/j.1365-2222.2001.01113.x
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发表时间：
2001-07-01
影响因子：
6.1
通讯作者：
Reyes-Benito, LV
中科院分区：
文献类型：
--
作者：
Hill, DJ;Hosking, CS;Reyes-Benito, LV
背景：双盲安慰剂对照食物激发试验（DBPCFC）是诊断食物过敏的金标准，耗时且并非没有风险。我们最近报告了牛奶、自我和花生的皮肤点刺试验（SPT）伤痕直径，在这些直径以上的婴儿和幼儿被转介用于调查可疑的食物过敏，在食物激发时显示出不良反应。我们称之为“100%诊断性SPT水平”。在这项研究中，我们比较了在体内和体外测量IgE抗体水平的三种常见的食物过敏原-牛奶，鸡蛋和花生在婴幼儿怀疑食物过敏，方法SPT和酶过敏吸附试验（EAST）对820例怀疑对牛奶和/或鸡蛋和/或花生过敏的< 2岁儿童进行了CAP值（1999年至2000年）和CAP值（1992年至1998年）。SPT水平以前被证明是诊断挑战证明牛奶过敏，结果McNemar's试验显示，鸡蛋和花生的“100%诊断SPT值”与EAST和CAP值（按制造商的定义与IgE食物过敏相关）比较，差异有显著性（P <0.05）。诊断性SPT水平和阳性EAST在识别不需要食物挑战的患者中的作用为牛奶（P=0.01）、鸡蛋（P
Background Double-blind placebo-controlled food challenges (DBPCFC), the gold standard for the diagnosis of food hypersensitivity, are time-consuming and not without risk. We have recently reported skin prick test (SPT) weal diameters to cow's milk, ego and peanut above which infants and young children referred for investigation of suspected food allergy showed an adverse reaction on food challenge. We have termed these the '100% diagnostic SPT levels'. In this study, we compare in vivo with in vitro measurement of IgE antibody levels to three common food allergens-cow's milk, egg and peanut in infants and young children with suspected food allergy, in order to reduce the need for food challenges.Methods SPT and Enzyme Allergo-sorbent Test (EAST) (from 1992 to 1998) and CAP values (from 1999 to 2000) were performed in 820 children < 2 years of age with suspected allergy to cow's milk and/or egg and/or peanut. SPT levels previously shown to be diagnostic of challenge-proven allergy to cow's milk, egg and peanut were used as the '100% diagnostic SPT levels' and compared with EAST and CAP values associated with IgE food allergy according to the manufacturer's definition.Results McNemar's test showed a significant difference between the '100% diagnostic SPT levels' and positive EAST in identifying patients who did not require food challenge for cow's milk (P=0.01), egg (P