Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
J Allergy Clin Immunol. 2010 May;125(5):1077-1083.e8. doi: 10.1016/j.jaci.2010.02.038.
Immune features of infants with food allergy have not been delineated.
We sought to explore the basic mechanisms responsible for food allergy and identify biomarkers, such as skin prick test (SPT) responses, food-specific IgE levels, and mononuclear cell responses, in a cohort of infants with likely milk/egg allergy at increased risk of peanut allergy.
Infants aged 3 to 15 months were enrolled with a positive SPT response to milk or egg and either a corresponding convincing clinical history of allergy to milk or egg or moderate-to-severe atopic dermatitis. Infants with known peanut allergy were excluded.
Overall, 512 infants (67% male) were studied, with 308 (60%) having a history of a clinical reaction. Skin test responses, detectable food-specific IgE, or both revealed sensitization as follows: milk, 78%; egg, 89%; and peanut, 69%. SPT responses and food-specific IgE levels were discrepant for peanut (15% for IgE > or = 0.35 kU(A)/L and negative SPT response vs 8% for positive SPT response and IgE <0.35 kU(A)/L, P = .001). Mononuclear cell allergen stimulation screening for CD25, cytokine-inducible SH2-containing protein (CISH), forkhead box protein 3 (FOXP3), GATA3, IL10, IL4, IFNG, and T-box transcription factor (TBET) expression by using casein, egg white, and peanut revealed that only allergen-induced IL4 expression was significantly increased in those with clinical allergy to milk (compared with nonallergic subjects) and in those sensitized to peanut, despite the absence of an increase in GATA3 mRNA expression.
Infants with likely milk/egg allergy are at considerably high risk of having increased peanut-specific IgE levels (potential allergy). Peanut-specific serum IgE levels were a more sensitive indicator of sensitization than SPT responses. Allergen-specific IL4 expression might be a marker of allergic risk. Absence of an increase in GATA3 mRNA expression suggests that allergen-specific IL-4 might not be of T-cell origin.
食物过敏婴儿的免疫特征尚未明确。
我们旨在探索导致食物过敏的基本机制，并在一组有发生花生过敏高风险的疑似牛奶/鸡蛋过敏婴儿中确定皮肤点刺试验（SPT）反应、食物特异性 IgE 水平和单核细胞反应等生物标志物。
纳入年龄在 3 至 15 个月之间、对牛奶或鸡蛋 SPT 阳性且有相应牛奶或鸡蛋过敏的明确临床病史或中重度特应性皮炎的婴儿。已知有花生过敏的婴儿被排除在外。
共有 512 名婴儿（67%为男性）参与了该研究，其中 308 名（60%）有临床过敏反应史。皮肤试验反应、可检测到的食物特异性 IgE 或两者均显示出如下致敏情况：牛奶 78%；鸡蛋 89%；花生 69%。SPT 反应和食物特异性 IgE 水平对花生不一致（IgE>或=0.35 kUA/L 且 SPT 阴性 15%，vs IgE<0.35 kUA/L 且 SPT 阳性 8%，P=0.001）。通过使用酪蛋白、蛋清和花生对 CD25、细胞因子诱导的 SH2 含有蛋白（CISH）、叉头框蛋白 3（FOXP3）、GATA3、IL10、IL4、IFNG 和 T 盒转录因子（TBET）的表达进行的单核细胞过敏原刺激筛选显示，仅对牛奶有临床过敏（与无过敏者相比）和对花生致敏的婴儿中，过敏原诱导的 IL4 表达显著增加，尽管 GATA3mRNA 表达没有增加。
疑似牛奶/鸡蛋过敏的婴儿发生花生特异性 IgE 水平升高（潜在过敏）的风险相当高。花生特异性血清 IgE 水平比 SPT 反应更能敏感地指示致敏情况。过敏原特异性 IL4 表达可能是过敏风险的标志物。GATA3mRNA 表达无增加提示过敏原特异性 IL-4 可能不是 T 细胞来源。
