Morisset M, Moneret-Vautrin D-A, Maadi F, Frémont S, Guénard L, Croizier A, Kanny G
Department of Internal Medicine, Clinical Immunology and Allergology, Nancy, France.
Allergy. 2003 Apr;58(4):295-9. doi: 10.1034/j.1398-9995.2003.00074.x.
Mustard allergy accounts for 1.1% of food allergies in children. However, double-blind placebo-controlled food challenge trials (DB PCFCs) have not yet been proposed.
To carry out DB PCFCs to determine the real frequency of mustard allergy in patients sensitized to mustard.
A prospective study was conducted in 30 subjects aged 3-20 years presenting positive prick tests to ground mustard seeds (Brassica nigra), mustard flour (B. juncea), metabisulfite-free strong mustard seasoning (B. juncea) and a commercialized allergenic extract (B. nigra). Twenty-seven subjects were screened for mustard-specific immunoglobulin E (IgE). PCFCs were carried out either DB or single blind (SB) with up to 1340 mg of metabisulfite-free seasoning.
The mean diameter of the wheal induced by prick tests with the allergenic extract was lower (n.s.) than that induced by the native mustard products: 5.8 mm (1.5-15) vs 6.9 mm (0.5-18) for B. nigra ground seeds, 7.8 mm (1-20) for B. juncea flour and 9.7 mm (3-20) for the strong mustard seasoning. The diameter of the wheal induced by the allergenic extract was significantly different from that induced by the mustard seasoning (P < 0.005). The mean of mustard specific-IgE values was 8.7 KU/l (0.35-72.4). Seven of 30 food challenges were considered positive. Mean prick test results in the positive and negative PCFC subgroups were 5.5 mm vs 5.9 mm for the commercialized extract, 10.9 mm vs 5.8 mm for B. nigra ground seeds (P < 0.01), 9.9 mm vs 7.1 mm for B. juncea flour (n.s. P > 0.25) and 11.5 mm vs 9.1 mm for the metabisulfite-free mustard seasoning (n.s. P > 0.1). Mean specific IgE values determined by CAP system radioallergosorbent test (Phadebas Pharmacia) were higher but not significantly so (P > 0.25) in the subgroup with mustard allergy (12.3 K/l vs 7.6 KU/l).
About 23.3% of the sensitized subjects were allergic to a routine dose of mustard. Positive prick tests and the presence of specific IgE were not predictive. SB PCFC or DB PCFC is required before recommending avoidance diets.
芥末过敏占儿童食物过敏的1.1%。然而，尚未有双盲安慰剂对照食物激发试验（DB PCFCs）的相关报道。
开展双盲安慰剂对照食物激发试验，以确定对芥末致敏患者中芥末过敏的实际发生率。
对30名年龄在3至20岁之间的受试者进行前瞻性研究，这些受试者对磨碎的芥菜籽（黑芥）、芥末粉（芥菜）、无偏亚硫酸氢盐的浓芥末调味料（芥菜）和一种商业化变应原提取物（黑芥）的点刺试验呈阳性。对27名受试者检测芥末特异性免疫球蛋白E（IgE）。采用双盲或单盲方式进行食物激发试验，使用剂量最高达1340毫克的无偏亚硫酸氢盐调味料。
变应原提取物点刺试验诱发的风团平均直径低于天然芥末产品诱发的风团平均直径（无统计学差异）：黑芥磨碎种子诱发的风团平均直径为5.8毫米（1.5 - 15），而天然黑芥产品诱发的为6.9毫米（0.5 - 18）；芥菜粉诱发的风团平均直径为7.8毫米（1 - 20）；浓芥末调味料诱发的风团平均直径为9.7毫米（3 - 20）。变应原提取物诱发的风团直径与芥末调味料诱发的风团直径有显著差异（P < 0.005）。芥末特异性IgE值的平均值为8.7 KU/l（0.35 - 72.4）。30次食物激发试验中有7次被判定为阳性。在食物激发试验阳性和阴性亚组中，商业化提取物的点刺试验平均结果分别为5.5毫米和5.9毫米；黑芥磨碎种子的点刺试验平均结果分别为10.9毫米和5.8毫米（P < 0.01）；芥菜粉的点刺试验平均结果分别为9.9毫米和7.1毫米（P > 0.25，无统计学差异）；无偏亚硫酸氢盐芥末调味料的点刺试验平均结果分别为11.5毫米和9.1毫米（P > 0.1，无统计学差异）。通过CAP系统放射变应原吸附试验（法玛西亚公司）测定的芥末过敏亚组中特异性IgE值较高，但无显著差异（P > 0.25）（12.3 K/l对7.6 KU/l）。
约23.3%的致敏受试者对常规剂量的芥末过敏。点刺试验阳性和特异性IgE的存在并无预测价值。在推荐避免食用某种食物的饮食之前，需要进行单盲食物激发试验或双盲食物激发试验。
