Pediatric Allergy, Department of Pediatrics, University Hospital Gasthuisberg, Leuven, Belgium.
Pediatr Allergy Immunol. 2012 Mar;23(2):117-23. doi: 10.1111/j.1399-3038.2011.01218.x. Epub 2011 Oct 21.
Secondary soy allergy occurring in tree pollen allergic patients may cause acute symptoms.
We selected children with birch pollen allergy suspected of also being soy allergic (SA). Soy allergy was proven based on one of the following: (i) a clear-cut clinical history; (ii) a positive provocation test; and (iii) elimination and reintroduction of soy. Skin prick tests (SPT) were performed with a commercial soy extract and with soy flour. Specific IgE to Gly m 4, Gly m 5, and Gly m 6 was determined by means of ImmunoCAP and ISAC. Eight soy-tolerant atopic children being CAP rGly m 4-negative served as a control group for skin testing.
Of 15 subjects with birch pollen allergy and being suspected of soy allergy, eight of them proved to be SA; 7/15 subjects proved to be soy tolerant (ST). Besides acute symptoms in 8/8 SA subjects, 3/8 subjects also had been suffering from severe chronic complaints because of soy allergy. SPT with commercial soy extract was negative in all SA and ST subjects tested. SPT with soy flour was positive in 8/8 SA and in 5/6 ST subjects, but negative in all 8 controls (p < 0.0001); the median weal diameter was 7.7 mm in SA subjects, compared to 3 mm in ST subjects (p < 0.01). The median IgE level to rGly m 4 using CAP and ISAC was, respectively, 32.4 kU/l and 4.0 ISU in SA subjects, compared to 6.2 kU/l and 0.4 ISU in ST subjects (p < 0.05). Analysis of IgE to nGly m 5 and nGly m 6, using CAP or ISAC, showed no significant differences between SA and ST subjects.
Secondary soy allergy may cause severe chronic besides acute symptoms. SPT with soy flour is a sensitive and specific tool in detecting soy sensitization. SPT with soy flour, CAP rGly m 4, and ISAC rGLY m 4 are valuable tools in the diagnosis of birch-pollen-associated secondary soy allergy.
在花粉过敏患者中发生的次级大豆过敏可能会导致急性症状。
我们选择了怀疑同时患有大豆过敏（SA）的桦树花粉过敏患儿。大豆过敏的诊断依据如下之一：（i）明确的临床病史；（ii）阳性激发试验；和（iii）大豆的排除和再引入。使用商业大豆提取物和大豆粉进行皮肤点刺试验（SPT）。通过 ImmunoCAP 和 ISAC 测定针对 Gly m 4、Gly m 5 和 Gly m 6 的特异性 IgE。8 名对大豆耐受的特应性儿童作为皮肤测试的对照组，他们的 CAP rGly m 4 结果为阴性。
在 15 名桦树花粉过敏并怀疑大豆过敏的受试者中，有 8 名证实为 SA；7/15 名受试者证实为大豆耐受（ST）。除了 8 名 SA 受试者均出现急性症状外，还有 3/8 名 SA 受试者还因大豆过敏而长期患有严重慢性疾病。在所有接受测试的 SA 和 ST 受试者中，商业大豆提取物的 SPT 均为阴性。大豆粉的 SPT 在 8/8 SA 和 5/6 ST 受试者中为阳性，但在所有 8 名对照组中均为阴性（p<0.0001）；SA 受试者的平均风团直径为 7.7mm，而 ST 受试者为 3mm（p<0.01）。使用 CAP 和 ISAC 测定的 rGly m 4 的 IgE 中位数分别为 32.4 kU/L 和 4.0 ISU，而在 ST 受试者中分别为 6.2 kU/L 和 0.4 ISU（p<0.05）。使用 CAP 或 ISAC 分析 IgE 对 nGly m 5 和 nGly m 6 ，在 SA 和 ST 受试者之间未发现显著差异。
次级大豆过敏可能导致除急性症状外的严重慢性症状。大豆粉的 SPT 是检测大豆致敏的敏感和特异性工具。大豆粉 SPT、CAP rGly m 4 和 ISAC rGLY m 4 是诊断桦树花粉相关次级大豆过敏的有价值的工具。
