Vally H, Misso N L A, Madan V
National Centre for Epidemiology and Population Health, ANU College of Medicine and Health Sciences, The Australian National University, Canberra ACT 0200, Australia.
Clin Exp Allergy. 2009 Nov;39(11):1643-51. doi: 10.1111/j.1365-2222.2009.03362.x. Epub 2009 Sep 22.
Sulphites are widely used as preservative and antioxidant additives in the food and pharmaceutical industries. Topical, oral or parenteral exposure to sulphites has been reported to induce a range of adverse clinical effects in sensitive individuals, ranging from dermatitis, urticaria, flushing, hypotension, abdominal pain and diarrhoea to life-threatening anaphylactic and asthmatic reactions. Exposure to the sulphites arises mainly from the consumption of foods and drinks that contain these additives; however, exposure may also occur through the use of pharmaceutical products, as well as in occupational settings. While contact sensitivity to sulphite additives in topical medications is increasingly being recognized, skin reactions also occur after ingestion of or parenteral exposure to sulphites. Most studies report a 3-10% prevalence of sulphite sensitivity among asthmatic subjects following ingestion of these additives. However, the severity of these reactions varies, and steroid-dependent asthmatics, those with marked airway hyperresponsiveness, and children with chronic asthma, appear to be at greater risk. In addition to episodic and acute symptoms, sulphites may also contribute to chronic skin and respiratory symptoms. To date, the mechanisms underlying sulphite sensitivity remain unclear, although a number of potential mechanisms have been proposed. Physicians should be aware of the range of clinical manifestations of sulphite sensitivity, as well as the potential sources of exposure. Minor modifications to diet or behaviour lead to excellent clinical outcomes for sulphite-sensitive individuals.
亚硫酸盐在食品和制药行业中被广泛用作防腐剂和抗氧化剂添加剂。据报道，敏感个体经局部、口服或肠胃外接触亚硫酸盐后会引发一系列不良临床反应，从皮炎、荨麻疹、脸红、低血压、腹痛和腹泻到危及生命的过敏和哮喘反应。接触亚硫酸盐主要源于食用含有这些添加剂的食品和饮料；然而，也可能通过使用药品以及在职业环境中接触到。虽然局部用药中亚硫酸盐添加剂引起的接触性敏感越来越受到认可，但摄入或肠胃外接触亚硫酸盐后也会出现皮肤反应。大多数研究报告称，哮喘患者摄入这些添加剂后，亚硫酸盐敏感性的患病率为3%至10%。然而，这些反应的严重程度各不相同，依赖类固醇的哮喘患者、气道反应性明显增高的患者以及患有慢性哮喘的儿童似乎风险更大。除了发作性和急性症状外，亚硫酸盐还可能导致慢性皮肤和呼吸道症状。尽管已经提出了一些潜在机制，但迄今为止，亚硫酸盐敏感性的潜在机制仍不清楚。医生应该了解亚硫酸盐敏感性的一系列临床表现以及潜在的接触源。对饮食或行为进行微小调整就能使亚硫酸盐敏感个体获得良好的临床效果。
