FOOD HYPERSENSITIVITY IN THE PATHOGENESIS OF ATOPIC DISORDERS

食物过敏在特应性疾病发病机制中的作用 皮炎(AD)和其他特应性疾病已经争论了很多年。 在20世纪30年代，恩格曼描述了一个对小麦敏感的儿童 小麦摄入后出现湿疹样皮肤变化，但仅限于局部 没有闭塞敷料的保护，表明食物诱导的作用 在皮炎的发展过程中出现瘙痒和抓挠。更多 最近的研究重新引起了人们对食物的作用的兴趣 超敏反应在特应性皮炎(AD)等发病机制中的作用 特应性精神障碍。然而，关于疾病定义的问题， 研究设计和控制的充分性不确定 食物在AD和其他特应性疾病的发病机制中，如哮喘。 主要的假设是食物过敏反应表现出 可识别的即刻和后期分量 临床上(客观物理发现的发展)和通过检测 肥大细胞和嗜碱性粒细胞特有的介体 血液循环。在有晚期反应的患者中 涉及细胞类型，可通过血清升高来检测 嗜酸性粒细胞阳离子蛋白和髓过氧化物酶。 第二个假设是延迟反应(超过12小时 质疑之后)由其他调查人员检测到的)是虚假的， 可能是因为研究的开放性和缺乏 测量结果的客观性。因此，在经历了一次 长期、双盲、安慰剂对照的挑战研究 症状评分或行为观察评分的差异将是 在安慰剂周和活动周之间检测到。

The role of food hypersensitivity in the pathogenesis of atopic dermatitis (AD) and other atopic diseases has been debated for years. In the 1930s, Engman described a wheat-sensitive child who developed eczematoid skin changes following wheat ingestion, but only on areas unprotected by occlusive dressing, suggesting a role for food-induced pruritus and scratching in the development of the dermatitis. More recently studies have renewed interest in the role of food hypersensitivity in the pathogenesis of atopic dermatitis (AD) and other atopic disorders. However, questions with respect to disease definition, study design, and adequacy of controls left uncertain the importance of food in the pathogenesis of AD and other atopic diseases, such as asthma. The primary hypothesis is that food hypersensitivity reactions exhibit both immediate and late-phase components that may be recognized clinically (development of objective physical findings) and by detection of mediators characteristic of mast cells and basophils in the circulating blood. In patients having late-phase reactions additional cell types are involved and may be detected by elevation of serum eosinophil cationic protein and myeloperoxidase. A secondary hypothesis is that the late reactions (more than 12 hours after challenge) detected by other investigators are artefactual, possibly due to the open nature of the studies and the lack of objectivity of the measured outcomes. Thus, in patients undergoing a prolonged, double-blinded, placebo-controlled challenge study, no differences in symptom scores or behavioral observation scores will be detected between placebo weeks and active weeks.