IGE-MEDIATED FOOD ALLERGY – EXTENSIVE REVIEW OF THE LITERATURE
IGE-MEDIATED FOOD ALLERGY – EXTENSIVE REVIEW OF THE LITERATURE
复制标题
IGE 介导的食物过敏 — 文献综述
作者：
D. Ebo;W. Stevens
摘要对食物的不良反应，即食物过敏和不耐受已引起相当大的关注。这篇综述着重于IgE介导的食物过敏的诊断和治疗，它被认为是导致大多数即刻类型的食物超敏反应的原因。临床上，这些反应的特征是在食用有害食物后几分钟或几小时内出现各种体征和症状。皮肤、鼻子、眼睛和/或肺部的反应可能是有限的或更普遍的。在更严重的情况下，可能会出现包括低血压、休克、心律失常和死亡在内的心血管症状。在对食物过敏的人中，IgE是针对自然产生的食物成分产生的，主要是糖蛋白，这些糖蛋白通常在加热和/或蛋白质分解后保持其过敏性。虽然成年人往往对鱼、甲壳类动物、花生和坚果过敏，但儿童往往对牛奶、蛋清、小麦和大豆过敏更频繁。“新出现的”食物过敏原包括热带水果、芝麻、木耳、香料和调味品。这些过敏通常代表对来自其他来源的过敏原的交叉过敏，例如花粉或天然橡胶乳胶。对IgE介导的食物过敏的评估依赖于仔细的病史、体检、适当的皮肤测试或食物提取物的体外测试，和/或双盲、安慰剂控制的食物挑战。回避仍然是治疗的主要方式。然而，过敏原可能是“隐藏的”，标签可能不准确或具有误导性，从而严重阻碍预防。严重过敏的患者应该随身携带一个装有肾上腺素、一种抗组胺药物和一种可注射的快速起效皮质类固醇的急诊箱。目前，除了出于研究目的，没有证据支持使用免疫疗法。“低过敏性”食品的生产因评估这种新型食品的致敏性潜力的方法不完善而受到阻碍。
Abstract Adverse reactions to food, i.e. food allergy and intolerance have gained considerable attention. This overview focuses on the diagnosis and management of IgEmediated food allergy that is believed to be responsible for most immediate-type food-induced hypersensitivity reactions. Clinically, these reactions are characterised by a variety of signs and symptoms that occur within minutes or hours after consumption of the offending food. Reactions may be limited or more generalised with involvement of the skin, nose, eyes, and/or lungs. In more severe cases, cardiovascular symptoms including hypotension, shock, cardiac dysrhythmias and death can occur. In food-allergic individuals, IgE is produced against naturally occurring food components, primarily glycoproteins that usually retain their allergenicity after heating and/or proteolysis. While adults tend to be allergic to fish, crustaceans, peanuts and tree nuts, children tend to be allergic to cow’s milk, egg white, wheat and soy more frequently. “Emerging” food allergens include tropical fruits, sesame seeds, psyllium, spices and condiments. These allergies frequently represent a cross-allergy to an allergen derived from another source, e.g. pollens or natural rubber latex. The evaluation of IgE-mediated food allergy relies on a careful history, physical examination, appropriate skin testing or in vitro testing with food extracts, and/or double blind, placebocontrolled food challenges. Avoidance remains the mainstay of therapy. However, allergens may be “hidden” and labelling can be non-precise or misleading, thereby severely hampering prevention. Patients with severe allergies should keep at hand an emergency kit with adrenaline, an antihistamine and an injectable rapid onset- of-action corticosteroid. At present there is no evidence to support the use of immunotherapy, except for research purposes. Production of “hypoallergenic” food is hampered by incomplete methods for assessing the allergenic potential of such novel foods.
影响因子：
158.5
作者：
SAMPSON, HA;MENDELSON, L;ROSEN, JP
通讯作者：
ROSEN, JP
影响因子：
5.1
作者：
SAMPSON, HA;SCANLON, SM
通讯作者：
SCANLON, SM