Utility of ovomucoid-specific IgE concentrations in predicting symptomatic egg allergy
Utility of ovomucoid-specific IgE concentrations in predicting symptomatic egg allergy
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DOI：
10.1016/j.jaci.2008.06.016
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发表时间：
2008-09-01
影响因子：
14.2
通讯作者：
Urisu, Atsuo
中科院分区：
文献类型：
--
作者：
Ando, Hitoshi;Moverare, Robert;Urisu, Atsuo
背景：对生鸡蛋白色过敏的儿童可能耐受少量的加热鸡蛋。卵类粘蛋白特异性IgE抗体可作为判断儿童能否耐受热处理鸡蛋的预测指标。目的：探讨检测鸡蛋白色、卵清蛋白和卵类粘蛋白特异性IgE抗体对鸡蛋过敏儿童的临床诊断价值。108例疑似鸡蛋过敏的患者（中位年龄34.5个月）接受了生鸡蛋和加热鸡蛋的双盲、安慰剂对照食物挑战。结果：38例患者对加热鸡蛋白色有过敏反应，29例仅对生鸡蛋白色有反应，41例耐受。研究的血清学参数之间观察到相关性。受试者操作特征分析表明，免疫组化检测白色蛋白对生鸡蛋白色过敏有一定的诊断价值。基于95%临床特异性的阳性判定点为7.4 kU（A）/L，基于95%临床敏感性的阴性判定点为0.6 kU（A）/L。对于对加热的鸡蛋白色的反应，卵类粘蛋白ImmunoCAP是上级的。阳性判定点为10.8kU（A）/L，阴性判定点为1.2kU（A）/L。结论：定量检测鸡蛋白色和卵类粘蛋白特异性IgE抗体，并根据推荐的特异性IgE阳性判定点和阴性判定点进行评价，对鸡蛋过敏的诊断有一定的参考价值。
Background: Children with allergy to raw egg white might tolerate low amounts of heated egg. Ovomucoid-specific IgE antibodies have been suggested to be predictors of whether children could tolerate heat-treated egg.Objective: The aim was to evaluate the clinical usefulness and added diagnostic value of measurements of IgE antibodies to egg white, ovalbumin, and ovomucoid in children with egg allergy.Methods: One hundred eight patients (median age, 34.5 months) with suspected egg allergy underwent double-blind, placebo-controlled food challenges with raw and heated egg. The outcomes of the challenges were related to the serum concentration of specific IgE antibodies and total IgE by using ImmunoCAP.Results: Reactions to heated egg white were observed in 38 patients (considered allergic to raw and heated egg), 29 patients reacted to only raw egg white, and 41 patients were tolerant. Correlation was observed between the serologic parameters studied. Receiver operating characteristic analysis showed that egg white ImmunoCAP was useful in the diagnosis of allergy to raw egg white. The positive decision point, based on 95% clinical specificity, was 7.4 kU(A)/L, and the negative decision point, based on 95% clinical sensitivity, was 0.6 kU(A)/L. For reaction to heated egg white, ovomucoid ImmunoCAP was superior. The positive decision point was 10.8 kU(A)/L, and the negative decision point was 1.2 kU(A)/L.Conclusions: Quantitative measurements of specific IgE antibodies to both egg white and ovomucoid and the evaluation against the suggested positive and negative decision points for specific IgE will be useful in the diagnosis of egg allergy.