Clinical food hypersensitivity: The relevance of duodenal immunoglobulin E-positive cells
Clinical food hypersensitivity: The relevance of duodenal immunoglobulin E-positive cells
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DOI：
10.1203/00006450-199810000-00004
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发表时间：
1998-10-01
影响因子：
3.6
通讯作者：
de' Angelis, G
中科院分区：
文献类型：
--
作者：
Caffarelli, C;Romanini, E;de' Angelis, G
由于实验室检测的可靠性较差，食物过敏的诊断是基于对双盲安慰剂对照食物刺激的临床反应。本研究的目的是评估十二指肠ige阳性细胞在食物过敏诊断中的价值。31名可能有食物过敏史的儿童接受了十二指肠活检、皮肤点刺试验和血清IgE抗体测定，并进行了消除饮食，然后进行了食物挑战。对12个月以下的患者进行开放式食物挑战，对可疑食物进行双盲安慰剂对照挑战。根据临床食物过敏情况将患者分为两组。第一组有13名食物过敏儿童。20个积极挑衅中有13个在挑战结束后12小时内引起反应，7小时后。第二组为对照组，包括18例阴性食物挑战患者。1组活检标本中ige阳性细胞数量明显高于2组（153.24 +/- 83.13 vs 18.4 +/- 18.9; p < 0.01）。与对照组相比，血清总IgE水平升高（p < 0.01），且与IgE阳性细胞数相关（p < 0.001, r = 0.62）。在所有延迟反应的细胞中都发现了增强的含IgE细胞，但约三分之一的皮肤点刺试验或针对有害食物的特异性血清IgE抗体呈阴性。我们的研究结果表明，对食物的全身反应与十二指肠黏膜中ige介导的反应有关。需要更大规模的研究来评估增加的ige阳性细胞数量在食物过敏诊断中的预测价值，特别是在延迟反应的儿童中。
Owing to poor reliability of laboratory tests, diagnosis of food allergy is based on clinical response to double-blind placebo-controlled food challenge. The aim of the present study was to assess the value of duodenal IgE-positive cells in the diagnosis of food allergy. Thirty-one children with a history of possible food allergy underwent duodenal biopsies, skin prick tests, and measurement of serum IgE antibodies, and were put on an elimination diet followed by food challenge. Open food challenges were performed in patients under 12 mo of age, and double-blind placebo-controlled challenges were for suspected foods. On the basis of clinical food hypersensitivity, patients were divided into two groups. Group 1 consisted of 13 children with food allergy. Thirteen of 20 positive provocations elicited reactions within 12 h from the end of the challenge, seven later. Group 2 was the control group and included 18 patients with negative food challenges. The number of IgE-positive cells in biopsy specimens was significantly more elevated in group 1 with respect to group 2 (153.24 +/- 83.13 versus 18.4 +/- 18.9; p < 0.01). Total serum IgE levels were elevated compared with that of the control group (p < 0.01) and correlated with the number of IgE-positive cells (p < 0.001, r = 0.62). Enhanced IgE-containing cells were found in all delayed reactors, but about one-third had negative skin prick tests or specific serum IgE antibodies to the offending foods. Our results showed that systemic reactions to foods are associated with an IgE-mediated response in the duodenal mucosa. Larger studies would be required to assess the predictive value of an increased number of IgE-positive cells in the diagnosis of allergy to food, especially in children with delayed reactions.