Food-dependent exercise-induced anaphylaxis: influence of concurrent aspirin administration on skin testing and provocation
Food-dependent exercise-induced anaphylaxis: influence of concurrent aspirin administration on skin testing and provocation
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DOI：
10.1046/j.1365-2133.2002.04601.x
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发表时间：
2002-03-01
影响因子：
10.3
通讯作者：
Ikezawa, Z
中科院分区：
文献类型：
--
作者：
Aihara, M;Miyazawa, M;Ikezawa, Z
目的探讨阿司匹林在食物依赖型运动性过敏反应(FDEIA)患者激发试验和皮肤点刺试验中的作用。此外，还对小麦依赖的FDEIA中的主要过敏原面筋进行了调查。方法对12例FDEIA患者进行激发试验和可疑食物的SPT。用食物、锻炼和阿司匹林的组合进行挑衅测试。用CAP系统FEIA放射变态反应吸附试验、SPT和组胺释放试验检测面筋特异性IgE。结果8例患者中有5例(62.5%)SPT反应增强。阿司匹林促进了七名患者中的五名(71%)的挑衅行为。在没有运动的情况下摄入小麦和阿司匹林引起了两名患者的症状。阿司匹林在一名患者中即使在少量小麦和运动的情况下也会引发症状。只有阿司匹林、小麦和运动的组合在一名患者中引发了过敏反应。11例小麦依赖型FDEIA患者中有9例特异性IgE、SPT和/或谷蛋白组胺释放试验阳性。结论阿司匹林可改善FDEIA的症状，在控制条件下预先服用阿司匹林可确诊FDEIA。实际上，这类患者应该避免服用阿司匹林。面筋似乎是这些小麦依赖型FDEIA患者的主要过敏原。
Background Provocation tests in patients with food-dependent exercise-induced anaphylaxis (FDEIA) are often negative, even after a sufficient quantity of the implicated food and exercise have been taken.Objectives To investigate the effect of aspirin in provocation tests and in skin prick testing (SPT) of patients with FDEIA. Gluten as a major allergen in wheat-dependent FDEIA was also investigated.Methods Provocation tests and SPT with suspected foods were performed in 12 patients with FDEIA. Provocation tests were performed with combinations of foods, exercise and aspirin. Detection of gluten-specific IgE was also performed by the CAP System FEIA radioallergosorbent test, SPT and a histamine release test.Results The SPT reaction was enhanced by pretreatment with oral aspirin in five of eight (62.5%) patients. Aspirin facilitated provocation in five of seven (71%) patients tested. Ingestion of wheat and aspirin without exercise provoked symptoms in two patients. Aspirin provoked symptoms even with a small amount of wheat and exercise in one patient. Only the combination of aspirin, wheat and exercise provoked anaphylaxis in one patient. Specific IgE, SPT and/or the histamine release test with gluten were positive in nine of 11 patients with wheat-dependent FDEIA.Conclusions Aspirin enhances symptoms of FDEIA, and prior ingestion of aspirin under controlled conditions can be used to confirm FDEIA. In practice, such patients should avoid aspirin ingestion. Gluten appears to be the major allergen in these patients with wheat-dependent FDEIA.