Allergen‐specific IgG4 over time: observation among adults with hydrolyzed wheat protein allergy
Allergen‐specific IgG4 over time: observation among adults with hydrolyzed wheat protein allergy
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过敏原特异性 IgG4 随时间的变化：对水解小麦蛋白过敏的成年人的观察
DOI：
10.1111/all.13866
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发表时间：
2019
期刊：
影响因子：
12.4
通讯作者：
Taniguchi Masami
中科院分区：
文献类型：
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作者：
Fukutomi Yuma;Teruuchi Yuya;Nakatani Eiji;Minami Takafumi;Sasagawa Yoshikiyo;Fukushima Masao;Kamide Yosuke;Sekiya Kiyoshi;Saito Hirohisa;Teshima Reiko;Adachi Reiko;Taniguchi Masami
根据编辑的说法，过敏原特异性IgG4抗体是过敏原免疫治疗机制中的关键角色，以及对过敏原的自然耐受。有关食物过敏儿童口服免疫治疗的研究报告称，治疗开始后，过敏原特异性IgG4水平升高，有时伴随着临床症状的改善。然而，很少有研究证实成人起病的食物过敏患者在重新开始食用因食物过敏而被淘汰的食物后特异性IgG4是否增加，以及特异性IgG4是否是疾病预后良好的标志。在日本，我们经历了由一种特定的小麦水解蛋白(HWP-IWA)引起的即时性小麦过敏症(IWA)的流行。4、5超过2000名患者(主要是成年人)在皮肤和/或鼻结膜致敏面部肥皂(Cha-no-Shizuku[日本福冈Yuuka])后发生IWA(主要是小麦依赖的运动引起的过敏反应)。4重要的是，大多数患者在停止使用肥皂几年后，对小麦过敏原的IgE反应性显著降低，并伴随着摄入小麦的症状减轻。6我们认为，观察本病的临床病程有助于我们了解肠道外致敏食物相关过敏原所致的其他成年型食物过敏的病原学及预后。
To the Editor, Allergen‐specific IgG4 antibody is a key player in the mechanism of allergen immunotherapy, as well as natural tolerance to allergens. Studies of oral immunotherapy in children with food allergy have reported increased allergen‐specific IgG4 levels after the initiation of therapy, which is sometimes accompanied by clinical improve‐ment. 1, 2 However, few studies have verified whether specific IgG4 in patients with adult‐onset food allergy increases after restarting consumption of the food which was eliminated due to food allergy3 and whether specific IgG4 is a marker for good disease prognosis. In Japan, we have experienced epidemics of immediate‐type wheat allergy (IWA) caused by a specific hydrolyzed wheat protein (HWP‐IWA). 4, 5 More than 2000 patients (mostly adults) developed IWA (mostly, wheat‐dependent exercise‐induced anaphylaxis) after skin and/or rhinoconjunctival sensitization to an HWP termed Glupearl 19S (Katayama Chemical Industries) contained in facial soap (Cha‐no‐Shizuku [Yuuka, Fukuoka, Japan]). 4 Importantly, most patients showed a significant reduction in IgE reactivity to wheat allergens accompanied by attenuated symptoms to ingested wheat several years after stopping the use of the soap. 6 We consider that observation of the clinical course of this disease might contribute to our understanding of the pathogen‐esis and prognosis of other disease entities of adulthood‐onset food al‐lergy induced by extra‐gut sensitization to food‐related allergens.