Beyer Kirsten
Division of Pediatric Allergy & Immunology, The Mount Sinai School of Medicine, New York, New York, USA.
Curr Opin Allergy Clin Immunol. 2003 Jun;3(3):189-97. doi: 10.1097/00130832-200306000-00007.
Diagnostic decision points for food allergen-specific serum IgE concentration and for skin prick test results have been established for several foods, reducing the requirement for food challenges in a number of patients. Many patients, however, still need to undergo oral food challenges because their food-specific IgE level is in the undefined range. In addition, diagnostic decision points could not be established for several foods. It appears that measurement of serum specific IgE concentrations to individual allergens is superior to determination of specific IgE to the crude food extract containing allergenic and nonallergenic proteins. This review will outline recent advantages in characterization of food allergens as well as the relevance of this knowledge for use in recently developed protein microarray technology.
Protein microarrays have been developed to profile allergen-specific IgE antibodies from human serum with the advantage of screening hundreds of allergens in parallel using minute amounts of blood. This technology, however, requires prior knowledge of the proteins to be studied. The identification and characterization of clinically relevant allergens have increased dramatically within the last several years. Relevant new allergens have been identified, especially in tree nuts and seeds. Interestingly, most of these allergens belong to the same family of seed storage proteins. In addition, known food allergens have been further characterized and IgE-binding sites have been determined. Moreover, 'informative' peptides shown to be predictive for the persistence of food allergy have been identified.
The combination of food allergen characterization and protein or peptide microarray technology will enable us to develop improved diagnostic tools in food allergy.
已确定了几种食物的食物过敏原特异性血清IgE浓度及皮肤点刺试验结果的诊断决策点，减少了许多患者进行食物激发试验的需求。然而，许多患者仍需进行口服食物激发试验，因为他们的食物特异性IgE水平处于未明确范围。此外，还有几种食物无法确定诊断决策点。似乎检测针对单个过敏原的血清特异性IgE浓度优于检测针对含有过敏原和非过敏原蛋白质的粗制食物提取物的特异性IgE。本综述将概述食物过敏原表征方面的最新优势以及这些知识在最近开发的蛋白质微阵列技术中的应用相关性。
已开发出蛋白质微阵列来分析人血清中的过敏原特异性IgE抗体，其优点是能用微量血液同时筛选数百种过敏原。然而，这项技术需要对要研究的蛋白质有先验知识。在过去几年中，临床相关过敏原的鉴定和表征有了显著增加。已鉴定出相关新过敏原，尤其是在坚果和种子中。有趣的是，这些过敏原大多属于同一类种子储存蛋白家族。此外，已知食物过敏原已得到进一步表征，IgE结合位点也已确定。而且，已鉴定出对食物过敏持续存在具有预测性的“信息性”肽。
食物过敏原表征与蛋白质或肽微阵列技术的结合将使我们能够开发出改进的食物过敏诊断工具。
