IMMUNOLOGICAL CHANGES ASSOCIATED WITH THE DEVELOPMENT OF TOLERANCE IN CHILDREN WITH COW MILK ALLERGY
IMMUNOLOGICAL CHANGES ASSOCIATED WITH THE DEVELOPMENT OF TOLERANCE IN CHILDREN WITH COW MILK ALLERGY
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DOI：
10.1016/s0022-3476(05)81788-3
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发表时间：
1992-09-01
影响因子：
5.1
通讯作者：
SAMPSON, HA
中科院分区：
文献类型：
--
作者：
JAMES, JM;SAMPSON, HA
本研究的目的是确定牛奶特异性抗体反应是否与牛奶过敏儿童临床耐受性的发展相关。每年对 29 名牛奶过敏患者进行双盲、安慰剂对照的食物挑战。 29 名患者中有 11 名（38%）失去了临床反应性。所有患者因这些食物挑战而被诊断时的中位年龄为 3 岁；每组中超过 80% 的患者出现特应性皮炎作为其症状的一部分。定期分析所有患者的酪蛋白特异性和 β-乳球蛋白特异性 IgE、IgG、IgG1 和 IgG4 抗体浓度。在临床上对牛奶产生耐受的患者中，与保留临床敏感性的患者相比，两种牛奶蛋白的 IgE 特异性抗体浓度和 IgE/IgG 特异性比率最初较低，并且随着时间的推移显着下降。在失去临床反应性的患者中，针对酪蛋白的 IgG1 和 IgG4 特异性抗体的浓度以及酪蛋白和 β-乳球蛋白的 IgE/IgG1 和 IgE/IgG4 比率显着降低。在上述任何评估时间中，两组中均未观察到 IgG 特异性浓度的差异。监测类似的酪蛋白特异性和 β-乳球蛋白特异性 IgE 浓度和 IgE/IgG 比率可能有助于预测哪些患者最终将失去对牛奶的临床反应性。
The purpose of this study was to determine whether cow milk-specific antibody responses correlated with the development of clinical tolerance in cow milk-allergic children. Double-blind, placebo-controlled food challenges were performed annually in 29 patients with cow milk allergy. Clinical reactivity was lost in 11 (38%) of 29 patients. The median age for all patients at the time of diagnosis by these food challenges was 3 years; more than 80% of patients in each group had atopic dermatitis as part of their presenting symptoms. Casein-specific and beta-lactoglobulin-specific IgE, IgG, IgG1, and IgG4 antibody concentrations were analyzed in all patients at regular intervals. In the patients becoming clinically tolerant to cow milk, the IgE-specific antibody concentrations and IgE/IgG-specific ratios for both milk proteins were lower initially and decreased significantly with time, in comparison with those in the group who retained clinical sensitivity. The concentrations of IgG1- and IgG4-specific antibody to casein and the IgE/IgG1 and IgE/IgG4 ratios for both casein and beta-lactoglobulin were significantly less in the patients losing clinical reactivity. No differences in the IgG-specific concentrations were observed in either group ot any of the evaluation times noted above. Monitoring similar casein-specific and beta-lactoglobulin-specific IgE concentrations and IgE/IgG ratios may help predict which patients will ultimately lose their clinical reactivity to cow milk.