Hospital Virgen del Camino, Pamplona, Spain.
J Investig Allergol Clin Immunol. 2009;19(6):423-32.
The diagnostic gold standard for food allergy is challenge with the culprit food, particularly in double-blind placebo-controlled challenge. This approach involves risks and consumes both time and resources. A more efficient system would be desirable. The detection of serum specific immunoglobulin E (sIgE) against the culprit food enables us to establish sensitization, although this is not always accompanied by clinical reactivity. Age, symptoms (immediate/late reaction, local/systemic reaction), concomitant condition (eg, atopic dermatitis, pollinosis) and selection sample criteria (eg, presence of symptoms related to ingestion, positive skin prick test result) can influence the detection and concentration of IgE against foods. We analyze the clinical usefulness of sIgE determination in light of studies in which oral food challenge is used as the diagnostic method. We review clinical usefulness at diagnosis and in the decision to reintroduce the food, as well as the prognostic value of the determination of IgE to foods.
食物过敏的诊断金标准是用可疑食物进行激发试验，尤其是双盲安慰剂对照激发试验。这种方法存在风险，并且既耗时又耗资源。人们希望有一个更有效的系统。检测针对可疑食物的血清特异性免疫球蛋白 E（sIgE）可以使我们确定致敏情况，尽管这并不总是伴有临床反应性。年龄、症状（即刻/迟发反应、局部/全身反应）、伴随疾病（如特应性皮炎、花粉症）和选择样本标准（如与摄入相关的症状存在、皮试阳性结果）会影响针对食物的 IgE 的检测和浓度。我们根据以口服食物激发试验作为诊断方法的研究，分析 sIgE 测定的临床实用性。我们综述了 sIgE 测定在诊断时和决定重新引入食物时的临床实用性，以及 IgE 对食物的测定的预后价值。
