Mehl A, Verstege A, Staden U, Kulig M, Nocon M, Beyer K, Niggemann B
Department of Pediatric Pneumology and Immunology, University Children's Hospital Charité of Humboldt University, Berlin, Germany.
Allergy. 2005 Aug;60(8):1034-9. doi: 10.1111/j.1398-9995.2005.00806.x.
Double-blind, placebo-controlled food challenges are time-consuming, expensive and not without risk to patients. Therefore, an in vitro test that could accurately diagnose food allergy would be of great value.
To evaluate the utility of the ratio of specific immunoglobulin E (IgE)/total IgE compared with specific IgE (sIgE) alone in predicting symptomatic food allergy.
We retrospectively analysed 992 controlled oral food challenges performed in 501 children (median age 13 months). The ratio of sIgE/total IgE was calculated and tested for correlation with the outcome of food challenges. Receiver operator characteristics (ROC)-curves were performed; predicted probabilities and predictive decision points were calculated.
A significant correlation was found between the ratio and the outcome of food challenges for cow's milk (CM), hen's egg (HE), and wheat, but not for soy. The ROC and predicted probability curves as well as sensitivity and specificity of the decision points of the ratio were similar to those of sIgE levels for CM, HE and wheat.
In view of the greater effort needed to determine the ratio, without benefit compared with the sIgE alone, the calculation of the ratio of sIgE/total IgE for diagnosing symptomatic food allergy offers no advantage for CM, HE, wheat or soy. For the majority of cases controlled oral food challenges still remain the method of choice.
双盲、安慰剂对照食物激发试验耗时、昂贵且对患者并非没有风险。因此，一种能够准确诊断食物过敏的体外试验将具有巨大价值。
评估特异性免疫球蛋白E（IgE）/总IgE比值与单独的特异性IgE（sIgE）相比在预测有症状食物过敏方面的效用。
我们回顾性分析了对501名儿童（中位年龄13个月）进行的992次对照口服食物激发试验。计算sIgE/总IgE比值，并测试其与食物激发试验结果的相关性。绘制受试者操作特征（ROC）曲线；计算预测概率和预测决策点。
发现牛奶（CM）、鸡蛋（HE）和小麦的该比值与食物激发试验结果之间存在显著相关性，但大豆的不存在。该比值的ROC曲线和预测概率曲线以及决策点的敏感性和特异性与CM、HE和小麦的sIgE水平相似。
鉴于确定该比值需要付出更多努力，且与单独的sIgE相比没有优势，计算sIgE/总IgE比值用于诊断有症状食物过敏对CM、HE、小麦或大豆均无优势。对于大多数病例，对照口服食物激发试验仍然是首选方法。
