Vávrová H, Heroldová M, Kucera P
Oddelení alergologie a klinické imunologie, Ustav imunologie 3. LF UK a FNKV Praha.
Cas Lek Cesk. 2008;147(7):355-9.
Food allergy is an immune mediated unwanted side effect to food. All types of hypersensitivity can be involved; the most prevalent is IgE mediated one. The diagnosis is based on the history, skin tests with allergens and detection of specific IgE. These procedures are not highly predictive for clinical reactivity to food allergens, true clinical reactivity can be confirmed by allergen challenge. Oral allergy syndrome is represented by mostly subjective symptoms in oral cavity, usually triggered by fruit or vegetable allergens, cross-reacting with pollen allergens. This cross-reactivity is based on protein homology and immunologic similarity. To confirm the diagnosis of food allergy, the ,,golden standard" is the double blind placebo controlled food challenge. The basic features of this test are discussed, particularly in the diagnosis of the oral allergy syndrome. Controlled food challenge is a useful test for patient's diagnosis confirmation, evaluation of other diagnostic tests or evaluation of food allergenicity.
食物过敏是一种由免疫介导的对食物产生的不良副作用。所有类型的超敏反应都可能涉及;最常见的是IgE介导的超敏反应。诊断基于病史、过敏原皮肤试验和特异性IgE的检测。这些程序对食物过敏原的临床反应性预测性不高,真正的临床反应性可通过过敏原激发试验来确认。口腔过敏综合征主要表现为口腔内的主观症状,通常由水果或蔬菜过敏原引发,与花粉过敏原发生交叉反应。这种交叉反应基于蛋白质同源性和免疫相似性。为了确诊食物过敏,“金标准”是双盲安慰剂对照食物激发试验。本文讨论了该试验的基本特征,特别是在口腔过敏综合征的诊断方面。对照食物激发试验对于确诊患者、评估其他诊断试验或评估食物致敏性是一项有用的试验。