Eysink P E D, Bindels P J E, Stapel S O, Bottema B J A M, Van Der Zee J S, Aalberse R C
Department of General Practice, Division of Public Health, Academic Medical Center, University of Amsterdam, the Netherlands.
Clin Exp Allergy. 2002 Apr;32(4):556-62. doi: 10.1046/j.0954-7894.2002.01335.x.
In children at high risk of inhalation allergy, food sensitization is associated with an increased risk for sensitization to inhalant allergens. Furthermore, this association was also found in a cross-sectional study.
To examine in a prospective study, whether levels of IgG to foods (i.e. mixture of wheat and rice, mixture of soy bean and peanut, egg white, cow's milk, meat, orange and potato) indicate an increased risk for the future development of IgE antibodies to inhalant allergens in a low-risk population and whether they can be used as predictors of the subsequent development of IgE antibodies in young, initially IgE-negative children.
Coughing children, aged 1-5, visiting their GPs, were tested for IgE antibodies to mite, dog and cat (RAST) and IgG (ELISA) to foods. All IgE-negative children were retested for IgE antibodies after two years. The IgG results (66 percentiles) of the first blood sample were compared to the RAST-scores of the second blood sample.
After two years, 51 out of 397 (12.8%) originally IgE-negative children, had become IgE-positive for cat, dog and/or mite. An increased IgG antibody level to wheat-rice (OR = 2.2) and to orange (OR = 2.0) indicated an increased risk of developing IgE to cat, dog or mite allergens. In addition to IgG to a mixture of wheat-rice and orange; total IgE, breastfeeding, eczema as a baby and age were the most important predictors for the subsequent development of IgE to inhalant allergens.
An increased IgG antibody level to a mixture of wheat-rice or orange, indicates an increased risk of developing IgE to cat, dog or mite allergens. This indicates that excessive activity of the mucosal immune system is present before IgE antibodies to airborne allergens can be demonstrated. Nevertheless, IgG to foods is not very helpful (with a positive predictive value of 16.5%, and negative predictive value of 90.6%) in identifying individual children at risk in clinical practice. However, besides other risk factors, IgG to wheat-rice and to orange could be useful as a screening test for studies in the early identification, i.e. before IgE antibodies can be detected, of children with an increased risk of developing IgE antibodies in the future.
在吸入性过敏高风险儿童中，食物致敏与吸入性过敏原致敏风险增加相关。此外，这一关联也在一项横断面研究中被发现。
在一项前瞻性研究中，检测低风险人群中针对食物（即小麦和大米混合物、大豆和花生混合物、蛋清、牛奶、肉类、橙子和土豆）的IgG水平是否表明未来发生吸入性过敏原IgE抗体的风险增加，以及它们是否可作为年幼的、最初IgE阴性儿童后续IgE抗体产生的预测指标。
对1至5岁因咳嗽前往全科医生处就诊的儿童进行针对螨虫、狗和猫的IgE抗体（放射变应原吸附试验）及针对食物的IgG（酶联免疫吸附测定）检测。所有IgE阴性儿童在两年后重新检测IgE抗体。将首次血样的IgG结果（第66百分位数）与第二次血样的放射变应原吸附试验分数进行比较。
两年后，397名最初IgE阴性儿童中有51名（12.8%）对猫、狗和/或螨虫的IgE转为阳性。小麦 - 大米混合物（比值比 = 2.2）和橙子（比值比 = 2.0）的IgG抗体水平升高表明发生猫、狗或螨虫过敏原IgE的风险增加。除了小麦 - 大米和橙子混合物的IgG外；总IgE、母乳喂养、婴儿期湿疹和年龄是后续发生吸入性过敏原IgE的最重要预测因素。
小麦 - 大米或橙子混合物的IgG抗体水平升高表明在能够检测到针对空气传播过敏原的IgE抗体之前，黏膜免疫系统存在过度活跃。然而，在临床实践中，针对食物的IgG在识别个体风险儿童方面帮助不大（阳性预测值为16.5%，阴性预测值为90.6%）。然而，除了其他风险因素外，小麦 - 大米和橙子的IgG可作为一种筛查试验，用于在未来发生IgE抗体风险增加的儿童早期识别研究中，即在能够检测到IgE抗体之前进行研究。
