Utility of food-specific IgE concentrations in predicting symptomatic food allergy
Utility of food-specific IgE concentrations in predicting symptomatic food allergy
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DOI：
10.1067/mai.2001.114708
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发表时间：
2001-05-01
影响因子：
14.2
通讯作者：
Sampson, HA
中科院分区：
文献类型：
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作者：
Sampson, HA
背景：双盲、安慰剂对照的食物激发试验被视为诊断食物过敏的金标准。然而，在对患有特应性皮炎和食物过敏的儿童及青少年的一项回顾性分析中，确定了特定食物的特异性IgE浓度，其能够以大于95%的确定性预测对鸡蛋、牛奶、花生和鱼类的临床反应性。
目的：本研究的目的是在前瞻性评估食物过敏中确定这些95%预测决策点的效用。
方法：使用法玛西亚CAP系统荧光酶免疫分析法，对100名因食物过敏评估而转诊的连续儿童及青少年的血清进行针对鸡蛋、牛奶、花生、大豆、小麦和鱼类的特异性IgE抗体分析。将食物特异性IgE值与病史以及皮肤点刺试验和食物激发试验的结果进行比较，以确定先前确定的95%预测决策点在识别特定食物激发试验中反应概率增加的患者方面的有效性。
结果：对100名儿童（62%为男性；中位年龄3.8岁；范围0.4 - 14.3岁）进行了食物过敏评估。通过病史或口服食物激发试验确定食物过敏的诊断。基于先前确定的针对鸡蛋、牛奶、花生和鱼类过敏的95%预测决策点，通过对血清中食物特异性IgE浓度进行定量，在这项前瞻性研究中诊断出的食物过敏超过95%被正确识别。
结论：在一项对因食物过敏评估而转诊的儿童及青少年的前瞻性研究中，先前确定的针对4种主要食物过敏原的食物特异性IgE抗体浓度的95%预测决策点在预测临床反应性方面是有效的。食物特异性IgE的定量是诊断儿童人群对鸡蛋、牛奶、花生和鱼类的症状性过敏的有用检测方法，并且可以使大量儿童无需进行双盲、安慰剂对照的食物激发试验。
Background: The double-blind, placebo-controlled food challenge is considered the gold standard for diagnosing food allergy, However, in a retrospective analysis of children and adolescents with atopic dermatitis and food allergy, discrete food-specific IgE concentrations were established that could predict clinical reactivity to egg, milk, peanut, and fish with greater than 95% certainty.Objective: The purpose of this investigation was to determine the utility of these 95% predictive decision points in a prospective evaluation of food allergy,Methods: Sera from 100 consecutive children and adolescents referred for evaluation of food allergy were analyzed for specific IgE antibodies to egg, milk, peanut, soy, wheat, and fish by using the Pharmacia CAP System FEIA. Food-specific IgE: values were compared with history and the results of skin prick tests and food challenges to determine the efficacy of previously established 95% predictive decision points in Identifying patients with increased probability of reacting during a specific food challenge.Results: One hundred children (62% male; median age, 3.8 years; range, 0.4-14.3 years) were evaluated for food allergy. The diagnosis of food allergy was established by means of history or oral food challenge, On the basis of the previously established 95% predictive decision points for egg, milk, peanut, and fish allergy, greater than 95% of food allergies diagnosed in this prospective study were correctly identified by quantifying serum food-specific IgE concentrations,Conclusion: In a prospective study of children and adolescents referred for evaluation of food allergy, previously established 95% predictive decision points of food-specific IgE antibody concentrations for 4 major food allergens were effective in predicting clinical reactivity, Quantification of food-specific IgE is a useful test for diagnosing symptomatic allergy to egg, milk, peanut, and fish in the pediatric population and could eliminate the need to perform double-blind, placebo-controlled food challenges in a significant number of children.