Ortolani C, Ispano M, Scibilia J, Pastorello E A
Centro di Allergologia e Immunologia Clinica, Ospedale Niguarda Cà Granda, Milan, Italy.
Allergy. 2001;56 Suppl 67:5-8. doi: 10.1111/j.1398-9995.2001.00901.x.
Adverse reactions to food may be toxic or non toxic, depending on the susceptibility to a certain food; non toxic reactions that involve immune mechanisms are termed allergy if they are IgE-mediated. If no immunological mechanism is responsible, it is termed intolerance. The following disorders are considered a consequence of food allergy: gastrointestinal reactions (oral allergy syndrome, vomiting, diarrhea, protein-induced enterocolitic syndrome, eosinophilic gastroenteritis); respiratory reactions (rhinitis, asthma, laryngeal edema); cutaneous reactions (urticaria-angioedema, atopic dermatitis); anaphylaxis. There is much recent evidence to consider celiac disease an immunological disorder. Food allergy diagnosis is based on history, SPT, specific IgE, food challenges. DBPCFC is fundamental for diagnosing true food allergy; patients who have had anaphylaxis to food must not undergo DBPCFC. Rapidly progressive respiratory reactions and anaphylactic shock are life-threatening reactions that can be caused by food allergy. The doses of food inducing anaphylaxis can be very low, therefore commercial cross-contamination with an unsuspected food during food processing can be risky for the food allergic patient. The prevention of severe anaphylactic food reactions may lie in interdisciplinary collaboration among allergologists, chemists, food technologists, and experts in food industry research.
食物不良反应可能是毒性的或非毒性的,这取决于对某种食物的易感性;如果涉及免疫机制的非毒性反应是由IgE介导的,则称为过敏。如果没有免疫机制参与,就称为不耐受。以下疾病被认为是食物过敏的后果:胃肠道反应(口腔过敏综合征、呕吐、腹泻、蛋白质诱导的小肠结肠炎综合征、嗜酸性粒细胞性胃肠炎);呼吸道反应(鼻炎、哮喘、喉水肿);皮肤反应(荨麻疹-血管性水肿、特应性皮炎);过敏反应。最近有很多证据表明乳糜泻是一种免疫性疾病。食物过敏的诊断基于病史、皮肤点刺试验(SPT)、特异性IgE、食物激发试验。双盲安慰剂对照食物激发试验(DBPCFC)是诊断真正食物过敏的基础;对食物有过敏反应的患者不得进行DBPCFC。快速进展的呼吸道反应和过敏性休克是食物过敏可能导致的危及生命的反应。引发过敏反应的食物剂量可能非常低,因此在食品加工过程中与未被怀疑的食物发生商业交叉污染对食物过敏患者可能有风险。严重食物过敏反应的预防可能在于过敏症专科医生、化学家、食品技术专家和食品工业研究专家之间的跨学科合作。