Effect of tree pollen specific, subcutaneous immunotherapy on the oral allergy syndrome to apple and hazelnut
Effect of tree pollen specific, subcutaneous immunotherapy on the oral allergy syndrome to apple and hazelnut
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DOI：
10.1111/j.1398-9995.2004.00626.x
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发表时间：
2004-12-01
期刊：
影响因子：
12.4
通讯作者：
Helbling, A
中科院分区：
文献类型：
--
作者：
Bucher, X;Pichler, WJ;Helbling, A
背景：特异性免疫疗法(SIT)治疗花粉过敏的疗效是公认的。然而，其对花粉相关食物过敏，特别是口腔过敏综合征(OAS)的影响尚不明确。目的：本前瞻性对照研究的目的是探讨在桦树花粉过敏个体中，坐在树上的花粉(主要是桦树)是否对苹果或榛子诱发的OAS有影响。方法：对27例由苹果或榛子诱发的OAS的桦树花粉过敏受试者进行开放式口腔激发试验(OPT)，每隔1年增加新鲜苹果或榛子粉的剂量(1~128g)。27例受试者中有15例接受SIT治疗，12例未接受治疗。结果：15例患者中有13例(87%)能明显增加(P<；0.001)苹果、榛子的进食量，且无症状体征。1年后，平均耐受量从12.6 g苹果增加到32.6 g苹果。相比之下，在12名没有SIT的人中，只有一人(8%)能够在没有症状的情况下摄入更高的量。在实验室参数评估中，SIT治疗组仅rBet v1的IgG4抗体在1年后显著增加(P<；0.01)。结论：研究表明，在桦树花粉过敏的个体中，SIT与含有桦树花粉的提取物一起坐对苹果或榛子的OAS有积极的影响。尽管有这样的结果，苹果/榛子的耐受量仍然很小。因此，SIT对OAS患者的治疗效果仍然有限。
Background: The efficacy of specific immunotherapy (SIT) in pollen allergy is well established. However, its effect on pollen associated food allergy particularly the oral allergy syndrome (OAS) is not definitely ascertained.Objective: The purpose of this controlled prospective study was to investigate whether SIT with tree pollen, mainly birch, has an effect on OAS induced by apple or hazelnut in birch pollen-allergic individuals.Methods: Twenty-seven birch pollen-allergic subjects with OAS induced by apple or hazelnut underwent open oral provocation tests (OPT) with increasing doses (1 to 128 g) of fresh apple or ground hazelnut 1 year apart. Fifteen of 27 subjects were treated with SIT and 12 were not. Skin-prick test with birch pollen, apple and hazelnut, and specific serum IgE, IgG and IgG4 to rBet v 1, apple and hazelnut were determined.Results: Thirteen of 15 (87%) SIT-treated subjects could eat significantly (P < 0.001) more of apple or hazelnut without any symptoms/signs. The average tolerated quantity increased from 12.6 to 32.6 g apple after 1 year in this group. In contrast, only one of 12 (8%) individuals without SIT was able to consume a higher amount without symptoms. On evaluating laboratory parameters, only IgG4 antibodies to rBet v 1 were found to be significantly (P < 0.01) increased in the SIT-treated group after 1 year.Conclusions: The study shows that SIT with extracts containing birch pollen has a positive impact on OAS to apple or hazelnut in birch pollen-allergic individuals. In spite of this outcome, the amount of apple/hazelnut tolerated is still small. Thus, the effect of SIT on the patients' management of OAS remains limited.