Department of Dermatology, Shimane University Faculty of Medicine, Enya-cho 89-1, Izumo 693-8501, Japan.
J Dermatol Sci. 2013 Sep;71(3):155-9. doi: 10.1016/j.jdermsci.2013.04.010. Epub 2013 Apr 22.
Food-dependent exercise-induced anaphylaxis (FDEIA) is a special form of IgE-mediated food allergy and exhibits allergic symptoms in combination of causative food-intake and triggers such as exercise. As the causative foods and the condition of triggers vary among patients, diagnosis of FDEIA is not always easy. Serum food-specific IgE tests, which are widely used in the diagnosis of FDEIA, have rather low sensitivity, because the tests mostly utilize crude extracts of foods. Concept of using defined allergen molecules has been proposed as the term "component-resolved diagnostics" for diagnosis of IgE-mediated allergy. Use of purified allergens such as recombinant omega-5 gliadin turned out to highly improve its sensitivity and specificity of the tests in the diagnosis of wheat-dependent exercise-induced anaphylaxis (WDEIA). Recently, CD203c expression-based basophil activation test (BAT) is reported to be useful in identifying adult patients with WDEIA and predicting causative allergens in WDEIA, when combined with appropriate allergens. Detection of serum allergen levels possibly gives useful information whether food challenge tests have been performed with sufficient strength.
食物依赖运动诱发的过敏反应（FDEIA）是一种特殊的 IgE 介导的食物过敏形式，表现为摄入致敏食物并同时接触运动等触发因素后出现过敏症状。由于患者的致敏食物和触发因素各不相同，因此 FDEIA 的诊断并不总是容易的。血清食物特异性 IgE 检测被广泛用于 FDEIA 的诊断，但由于这些检测大多使用食物的粗提取物，因此其敏感性相对较低。使用过敏原分子的概念被提出作为“成分解析诊断”的术语，用于 IgE 介导的过敏反应的诊断。使用纯化过敏原，如重组ω-5 麦醇溶蛋白，已被证明可显著提高其在小麦依赖运动诱发的过敏反应（WDEIA）诊断中的敏感性和特异性。最近，基于 CD203c 表达的嗜碱性粒细胞活化试验（BAT）被报道可与适当的过敏原结合，用于识别成人 WDEIA 患者，并预测 WDEIA 的致敏原。检测血清过敏原水平可能会提供有用的信息，即食物激发试验是否已进行足够强度的激发。
