The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy
The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy
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DOI：
10.1016/j.jaci.2008.04.014
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发表时间：
2008-07-01
影响因子：
14.2
通讯作者：
Sampson, Hugh A.
中科院分区：
文献类型：
--
作者：
Maloney, Jennifer M.;Rudengren, Magnus;Sampson, Hugh A.
背景：诊断食物过敏的金标准是双盲、安慰剂对照的食物激发试验。诊断性食物特异性IgE水平可能有助于诊断食物过敏和规避食物challenges.Objectives的需要：本研究的目的是确定食物特异性IgE测量识别症状性花生，树坚果和种子过敏的实用性，并增加这些食物之间的关系。被怀疑对花生或树坚果过敏的患者回答了一份关于他们感知的食物过敏的问卷。过敏原特异性诊断是基于问卷调查，病史，并在相关时，皮肤点刺试验和血清特异性IgE水平。通过使用ImmunoCAP Specific IgE（Phadia，Inc，Uppsala，Sweden）分析患者血清中花生、坚果和种子的特异性IgE抗体。结果：对324例患者（61%男性;中位年龄6.1岁;范围0.2-40.2岁）进行了评价。这些患者是高度特应性的（57%患有特应性皮炎，58%患有哮喘）。大多数花生过敏患者对坚果过敏（86%），34%有临床过敏记录。采用Logistic回归分析方法估计诊断与过敏原特异性IgE水平之间的关系。提出了花生和核桃的诊断决策点。概率曲线绘制花生，芝麻，和几个树坚果。腰果和开心果之间的高度相关性，山核桃和walnut.Conclusions：食物特异性IgE的定量是一个有价值的工具，将有助于诊断症状性食物过敏，并可能减少需要双盲，安慰剂对照的食物挑战。
Background: The gold standard for diagnosing food allergy is the double-blind, placebo-controlled food challenge. Diagnostic food-specific IgE levels might assist in diagnosing food allergies and circumventing the need for food challenges.Objectives: The purpose of this study was to determine the utility of food-specific IgE measurements for identifying symptomatic peanut, tree nut, and seed allergies and to augment what is known about the relationships among these foods.Methods: Patients referred for suspected peanut or tree nut allergies answered a questionnaire about their perceived food allergies. Allergen-specific diagnoses were based on questionnaire, medical history, and, when relevant, skin prick tests and serum specific IgE levels. Sera from the patients were analyzed for specific IgE antibodies to peanuts, tree nuts, and seeds by using ImmunoCAP Specific IgE (Phadia, Inc, Uppsala, Sweden).Results: Three hundred twenty-four patients (61% male; median age, 6.1 years; range, 0.2-40.2 years) were evaluated. The patients were highly atopic (57% with atopic dermatitis and 58% with asthma.). The majority of patients with peanut allergy were sensitized to tree nuts (86%), and 34% had documented clinical allergy. The relationship between diagnosis and allergen-specific IgE levels were estimated by using logistic regression. Diagnostic decision points are suggested for peanut and walnut. Probability curves were drawn for peanut, sesame, and several tree nuts. High correlations were found between cashew and pistachio and between pecan and walnut.Conclusions: Quantification of food-specific IgE is a valuable tool that will aid in the diagnosis of symptomatic food allergy and might decrease the need for double-blind, placebo-controlled food challenges.