Departments of Paediatrics Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Pediatr Allergy Immunol. 2011 Feb;22(1 Pt 1):50-3. doi: 10.1111/j.1399-3038.2010.01031.x.
Food atopy is important but inadequately studied among children with atopic dermatitis (AD). We evaluated whether any association existed between AD severity, quality of life, total IgE, eosinophil counts, and the number of food items sensitized. Specific IgE of ten common food items was measured for a group of consecutive AD patients (n=85) enrolled during a randomized trial and correlated the findings with eczema severity. Twenty-four patients (28%) were negative for any of the ten common food items. The most commonly sensitized foods were shrimp (54%), egg white (43%), wheat (42%), and peanut (41%). Atopy to beef as a protein and orange as a fruit were least common among the food items studied, even among patients positive for 8-9 IgE items. Patients with severe AD (objective SCORAD>40) were more likely to be positive for at least one of the food items (Yates corrected p=0.024 for ≥1 food-specific IgE in severe vs. moderate AD, OR 3.42 and 95% CI 1.15-10.32); and for at least seven of the food items (p=0.001 for ≥7 food-specific IgE vs. nil with OR 11.67 and 95% CI 2.29-67.77), respectively. The Spearman coefficients between the number of positive food-specific IgE and total SCORAD, objective SCORAD, area of AD involvement, Children's Dermatology Life Quality Index (CDLQI), total IgE levels, and eosinophil counts were 0.42 (p<0.001), 0.45 (p<0.001), 0.50 (p<0.001), 0.17 (p=0.116), 0.80 (p<0.001), and 0.22 (p=0.043), respectively. Specific IgE levels for beef correlated with all the other food-specific IgE levels, including cow's milk (ρ=0.061, p<0.001) and soy (ρ=0.70, p<0.001). The number of common food items sensitized correlated with disease severity, extent, and total IgE levels. IgE sensitization to beef protein is unlikely in the majority of children with AD, but its serum IgE level is associated with disease severity and risk of sensitization to other foods.
食物过敏在特应性皮炎(AD)儿童中很重要,但研究不足。我们评估了 AD 严重程度、生活质量、总 IgE、嗜酸性粒细胞计数和致敏食物数量之间是否存在任何关联。对一组连续的 AD 患者(n=85)进行了一项随机试验,测量了十种常见食物的特异性 IgE,并将结果与湿疹严重程度相关联。24 名患者(28%)对十种常见食物中的任何一种均呈阴性。最常见的致敏食物是虾(54%)、蛋清(43%)、小麦(42%)和花生(41%)。在研究的食物中,对牛肉作为一种蛋白质和橙子作为一种水果的过敏反应是最不常见的,即使在对 8-9 种 IgE 项目呈阳性的患者中也是如此。严重 AD 患者(客观 SCORAD>40)更有可能对至少一种食物呈阳性(Yates 校正 p=0.024,严重 AD 与中度 AD 相比,至少有一种食物特异性 IgE 阳性,OR 3.42,95%CI 1.15-10.32);至少有七种食物阳性(p=0.001,与零相比,至少有七种食物特异性 IgE 阳性,OR 11.67,95%CI 2.29-67.77)。阳性食物特异性 IgE 数量与总 SCORAD、客观 SCORAD、AD 受累面积、儿童皮肤病生活质量指数(CDLQI)、总 IgE 水平和嗜酸性粒细胞计数之间的 Spearman 系数分别为 0.42(p<0.001)、0.45(p<0.001)、0.50(p<0.001)、0.17(p=0.116)、0.80(p<0.001)和 0.22(p=0.043)。牛肉特异性 IgE 水平与其他所有食物特异性 IgE 水平相关,包括牛奶(ρ=0.061,p<0.001)和大豆(ρ=0.70,p<0.001)。常见致敏食物数量与疾病严重程度、范围和总 IgE 水平相关。在大多数 AD 儿童中,对牛肉蛋白的 IgE 致敏不太可能,但它的血清 IgE 水平与疾病严重程度和对其他食物致敏的风险相关。