ROLE OF FOOD HYPERSENSITIVITY IN ATOPIC DERMATITIS

食物过敏在特应性皮炎中的作用

• 批准号: 3128525
• 负责人: Hugh A Sampson
• 金额: $ 15.82万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1982
• 资助国家: 美国
• 起止时间: 1982-08-01 至 1986-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3128525
• 关键词: Leguminoseae; T lymphocyte; adult human (21+); antiallergic agents; atopic dermatitis; child (0-11); egg food product; enzyme linked immunosorbent assay; erythema; food hypersensitivity; gastrointestinal nutrient absorption; histamine release; human subject; immunoglobulin A; immunoglobulin E; immunoglobulin G; longitudinal human study; milk; nutrition related tag; pruritis; serology /serodiagnosis; wheat

This research is designed to explore the role of IgE-mediated reactions to foods in the pathogenesis of atopic dermatitis (AD) and potential mechanisms involved. Studies over the past 3 years have identified 63/113 children with severe AD who developed immediate hypersensitivity reactions following double-blind placebo-controlled food challenges (DBPCFC); 84% of positive responses involved cutaneous symptoms consisting of a markedly pruritic, erythematous macular or morbilliform rash. A significant rise in plasma histamine was demonstrated only in a group of patients experiencing positive oral challenges, thus implicating mast cell/basophil involvement in the pathogenesis of food induced symptoms. Abstinence from the offending food has led to significant improvement in most children and a loss of hypersensitivity after 1-2 years in 60% (18/30) cases. Proposed studies will continue to evaluate the natural history of food hypersensitivity in children with AD. Using AD patients with food hypersensitivity diagnosed by DBPCFC, potential pathogenic mechanisms will be sought: 1) changes in skin histamine, eosinophil major basic protein, and arachidonic acid metabolites as measured in skin blister fluid, 2) abnormal gut permeability as defined by increased antigenemia, and 3) possible aberrant gut-associated and systemic immunological responses. The effects of prolonged antigen restriction on the resolution of food hypersensitivity, eczematoid rash, and concomitant changes in gut and systemic immunological parameters will be evaluated. Standard diagnostic procedures (skin testing, RAST, antigen-specific IgG) and others (ELISA assays developed for detecting circulating food antigens, serum and salivary antigen-specific IgA, and crossed-radioimmunoelectrophoresis developed with I125 labeled anti-human IgE, IgA, and IgG) will be examined for their usefulness in detecting and following clinically significant food allergy as defined by DBPCFC. In addition, the antigenic determinants of two major allergens, ovalbumin and Beta-lactoglobulin, will be characterized using a panel of monoclonal antibodies and evaluated for allergenicity. Digestibility of various food antigens will be assessed using an immobilized digestive enzyme system and the allergenicity of these breakdown products evaluated using sera from patients sensitive to specific foods.

本研究旨在探讨IgE介导的反应对 食物在特应性皮炎（AD）发病机制中的作用及其潜在的 涉及的机制。 过去3年的研究发现，63/113 发生速发型超敏反应的重度AD儿童 在双盲安慰剂对照食物挑战（DBPCFC）后; 84%的 阳性反应涉及皮肤症状，包括明显的 麻疹性、斑疹性或麻疹样皮疹。 显著上升 血浆组织胺仅在一组患者中证实， 口腔激发试验阳性，因此提示肥大细胞/嗜碱性粒细胞参与 食物诱发症状的发病机制。 禁欲 令人不快的食物导致了大多数儿童的显著改善， 60%（18/30）的病例在1-2年后超敏反应消失。 拟议中的研究将继续评估食物的自然历史 AD患儿超敏反应。 用AD患者的食物 DBPCFC诊断的超敏反应，潜在的致病机制将 寻求：1）皮肤组胺，嗜酸性粒细胞主要碱性蛋白， 和花生四烯酸代谢物，如在皮肤水疱液中测量的，2） 异常肠道通透性，定义为抗原血症增加，和3） 可能的异常肠道相关和全身免疫反应。 的 延长抗原限制对食物分解的影响 超敏反应、湿疹样皮疹以及伴随的肠道和 将评价全身免疫学参数。 标准诊断 程序（皮肤测试、RAST、抗原特异性IgG）和其他（ELISA 为检测循环食物抗原、血清和 唾液抗原特异性伊加和交叉放射免疫电泳 用I125标记的抗人IgE、伊加和IgG显色） 用于检测和跟踪临床重要食物 DBPCFC定义的过敏。 此外，抗原决定簇的 两种主要的过敏原，卵清蛋白和β-乳球蛋白， 使用一组单克隆抗体进行表征， 致敏性 将评估各种食物抗原的消化率 使用固定化的消化酶系统， 使用对特异性抗体敏感的患者血清评价分解产物 食品