Patriarca Giampiero, Nucera Eleonora, Pollastrini Emanuela, Roncallo Chiara, De Pasquale Tiziana, Lombardo Carla, Pedone Claudio, Gasbarrini Giovanni, Buonomo Alessandro, Schiavino Domenico
Department of Allergy, Catholic University, Policlinico Gemelli, Rome, Italy.
Dig Dis Sci. 2007 Jul;52(7):1662-72. doi: 10.1007/s10620-006-9245-7. Epub 2007 Jan 24.
The possibility of obtaining oral desensitization in patients with food allergy is still a matter of debate. We decided to evaluate the safety and efficacy of standardized protocols for oral desensitization with the most common food allergens. Forty-two children (ages up to 16 years) diagnosed as affected by food allergy (on the basis of clinical history, skin prick tests, measurement of specific IgE, and double-blind, placebo-controlled food challenge) underwent a sublingual-oral desensitizing treatment according to new standardized protocols. The control group consisted of 10 patients who followed an elimination diet. The treatment was successfully completed by 85.7% of the patients. Specific IgE showed a significant decrease, while specific IgG(4) showed a significant increase, in all treated patients. The immunological modifications observed in our patients lead us to hypothesize that oral tolerance may be mediated by the same mechanisms as those involved in traditional desensitizing treatments for respiratory and insect sting allergy.
食物过敏患者实现口服脱敏的可能性仍是一个有争议的问题。我们决定评估使用最常见食物过敏原进行口服脱敏标准化方案的安全性和有效性。42名被诊断为食物过敏的儿童(年龄最大16岁,根据临床病史、皮肤点刺试验、特异性IgE测量以及双盲、安慰剂对照食物激发试验确诊)按照新的标准化方案接受了舌下-口服脱敏治疗。对照组由10名遵循排除饮食的患者组成。85.7%的患者成功完成了治疗。所有接受治疗的患者中,特异性IgE显著降低,而特异性IgG(4)显著升高。我们在患者中观察到的免疫改变使我们推测,口服耐受可能由与传统呼吸道和昆虫叮咬过敏脱敏治疗相同的机制介导。