Imai Takanori, Komata Takatsugu, Ogata Mika, Tomikawa Morimitsu, Tachimoto Hiroshi, Shukuya Akinori, Ebisawa Motohiro
National Hospital Organization, Sagamihara National Hospital, Department of Pediatrics, Japan.
Arerugi. 2007 Oct;56(10):1285-92.
Prevalence of food allergy is the most frequent during infancy, and it is gradually decreasing with age. We can not distinguish patients developing tolerance from those with persistent food allergy, therefore we are unable to advice patients accelerating the development of tolerance. To clarify the factors developing tolerance or intolerance, we conducted the following study.
Patients who were diagnosed as food allergy to hen's egg, or cow's milk or wheat in infancy by the definitive history of positive food allergic reactions or food provocation tests were recruited to this study. Patients were divided into two groups; one (prolonged group, n=27) is those who needed to eliminate some of the main offending foods even at the age of 6 years old and the other (tolerized group, n=37) is those who had released all main offending foods by the age of 6 years old.
The factors which distinguished the prolonged group from the tolerized group were the positive clinical history of the atopic dermatitis and its prolonged clinical course, past history of anaphylactic shock, and maximum number of offending foods in the past clinical history. The specific IgE against main antigens such as egg white, cow's milk and wheat in the tolerized group was lower compared to that in the prolonged group, whereas no significant difference was found in non specific IgE value, peripheral eosinophil counts, and specific IgE against other antigens.
We could find the clinical factors discriminating food allergy patients against three major food allergen among children developing tolerance by the age of 6 years old form those without tolerance.
食物过敏的患病率在婴儿期最高,且随年龄增长逐渐降低。我们无法区分已产生耐受的患者和持续存在食物过敏的患者,因此无法建议患者加速耐受的形成。为了阐明形成耐受或不耐受的因素,我们进行了以下研究。
通过明确的食物过敏反应阳性病史或食物激发试验,招募在婴儿期被诊断为对鸡蛋、牛奶或小麦过敏的患者参与本研究。患者被分为两组;一组(持续过敏组,n = 27)是那些即使到6岁仍需避免一些主要致敏食物的患者,另一组(耐受组,n = 37)是那些在6岁时已解除所有主要致敏食物的患者。
区分持续过敏组和耐受组的因素有特应性皮炎的阳性临床病史及其延长的病程、过敏性休克病史以及既往临床病史中致敏食物的最大数量。与持续过敏组相比,耐受组中针对主要抗原如蛋清、牛奶和小麦的特异性IgE较低,而非特异性IgE值、外周嗜酸性粒细胞计数以及针对其他抗原的特异性IgE则无显著差异。
我们能够找出在6岁时已产生耐受的儿童与未产生耐受的儿童中,区分对三种主要食物过敏原过敏的食物过敏患者的临床因素。