STUDY ON THE BENEFICIAL EFFECT OF ALLERGY LABELLING SYSTEM OF PROESSED FOODS ON THE QUALITY OF LIFE OF CHILDREN WITH FOOD ALLERGY AND ITS CLINICAL EVALUATION

通过对家长、儿科医生、护理人员和营养师进行问卷调查，研究加工食品中特定成分过敏标识制度对食物过敏儿童生活质量的有益影响。只有57.4%的家长、59.1%的营养师、45.7%的儿科医生和38.5%的护理人员认为食物过敏婴儿的生活质量因过敏标签制度而得到改善。超过一半的儿童难以理解特定成分的替代声明。20.0%的儿科医生曾遇到过患者在食用未标注与该反应有关的过敏原的加工食品后出现过敏反应。有未标明过敏原含量超过10μg/g的食品，也有过敏原浓度低于10μg/g的食品，但一餐中过敏原的含量超过200μg，足以引起高度敏感婴儿的过敏反应。建立了一套与市售卵白蛋白专用检测试剂盒相匹配的、灵敏度高、特异性强的食品中鸡蛋抗原的ELISA检测系统。该系统不适合作为成分的鸡蛋蛋白的检测，但与临床观察相一致，适合评价致敏性的降低。对嗜碱性细胞组胺释放试验的研究表明，几ng的过敏原量就足以使从外周血中分离出来的嗜碱性细胞释放组胺，这表明可能需要比现有系统标记更少量的指定成分。这些结果被纳入临床使用的饮食咨询指南。

The beneficial effect of allergy labeling system of specified ingredients in the processed foods on the quality of life (QOL) of children with food allergy was studied using questionnaire for parents, pediatricians, nursing staff and dietitian. QOL of infants with food allergy was considered to have improved thanks to allergy labeling system only by 57.4% of their parents, 59.1% of dietitians, 45.7% of pediatricians, 38.5% of nursing staffs. More than half of them had difficulty in understanding the alternative declaration of specified ingredients.20.0% of pediatricians had experienced patients who demonstrated hypersensitivity reaction after intake of processed food with no labeling about allergen concerned with the reaction. There were foods without labeling in which more than 10μg/g of allergen were contained and foods in which the concentration of allergen was less than 10μg/g, but the amount of allergen exceeded 200μg as a meal: enough amount to cause allergic reaction in highly sensitized infants.We could establish ELISA system to assay the amount of egg antigen in foods with sensitivity and specificity compatible with commercially available specified measuring kit for ovalbumin. This system was not suitable for the detection of egg protein as an ingredient but was suitable to evaluate reduction of allergenicity compatible with clinical observation. Studies on the basophil histamine release test revealed that the amount of several ng of allergen was enough to release histamine from basophils separated from peripheral blood, indicating the possibility of necessity of labeling of smaller amount of specified ingredients than the existing system.These results were included n the dietary counseling guideline for clinical use.