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[托木斯克地区儿童对花生和榛子的食物过敏患病率]

[The prevalence of food allergy to peanut and hazelnut in children in Tomsk Region].

作者信息

Fedorova O S, Ogorodova L M, Fedotova M M, Evdokimova T A

出版信息

Vopr Pitan. 2014;83(1):48-54.

Abstract

Food allergy to peanuts and nuts is an actual problem of practical health care, associated with significant prevalence of this disease, severe clinical symptoms and difficulty of diet organization. Purpose of the study--to study the prevalence of food allergy to peanut and hazelnut in Russian children, the investigation of clinical characteristics of this disease, and the mechanisms of sensitization to allergen components. The cross-sectional study was performed in the framework of the EuroPrevall (No FP6-2006-TTC-TU-5 Proposal 045879). The first stage was performed in random samples of primary schoolchildren aged 7-10 years (n = 13 010) from the Tomsk Region, Russia using a standardized questionnaire. The case-control sample was recruited for the second stage (n = 1288). Thus who reported adverse reactions to food in the screening stage were considered as cases (n = 652), children without reported reactions were controls (n = 636). The case-control stage included the completion of a clinical questionnaire, skin-prick test (ALK-Abelly, Spain), serum specific IgE measurement and component-resolved diagnostic: IgE measurement of allergen components of peanut (Ara h1, Ara h26, Ara h34, Ara h8), hazelnut (Cor a1, Cor a8, Cor a11) and birch allergen Bet v1 (ImmunoCAP, Phadia, Sweden). The prevalence of food allergy to peanut and hazelnut in children aged 7-10 years in the Tomsk region is 0.08 and 0.09%, respectively. The manifestation of the food allergy to nuts occurs in the preschool years, main reactions associated with allergy to nuts were oral allergy syndrome (75-80%), gastrointestinal disorders (60-80%) and itching skin rash (20-50%). Sensitization to birch is significantly correlated with the level of specific IgE to hazelnut (r = 0.53, p < 0.05) and peanut (r = 0.56, p < 0.05). Sensitization to heat-labile proteins peanut Ara h8 (12.3%) and hazelnut Cor a1 (8.8%) (homologues of Bet v1) dominates in the sample of children with food sensitization, that determines the cross-reactivity mechanism in the formation of food sensitization in the studied sample. The prevalence of allergies to peanut and hazelnut in Russia is much lower than in Europe and North America. Sensitization to these foods develops by the mechanism of cross-reactivity with birch pollen allergen. This type of sensitization determines mild clinical symptoms of allergy to hazelnut and peanut.

摘要

对花生和坚果的食物过敏是实际医疗保健中的一个现实问题,与这种疾病的高发病率、严重的临床症状以及饮食安排的困难相关。研究目的——研究俄罗斯儿童对花生和榛子的食物过敏患病率,调查这种疾病的临床特征以及对过敏原成分的致敏机制。这项横断面研究是在欧洲患病率研究(欧洲第六框架计划 - 2006 - 技术合作 - 技术转让 - 5 提案 045879)框架内进行的。第一阶段是对俄罗斯托木斯克地区 7 - 10 岁的小学生随机样本(n = 13010)使用标准化问卷进行。第二阶段招募了病例对照样本(n = 1288)。因此,在筛查阶段报告有食物不良反应的人被视为病例(n = 652),未报告有反应的儿童为对照(n = 636)。病例对照阶段包括完成临床问卷、皮肤点刺试验(ALK - 阿贝利,西班牙)、血清特异性 IgE 测量以及成分分辨诊断:测量花生(Ara h1、Ara h26、Ara h34、Ara h8)、榛子(Cor a1、Cor a8、Cor a11)和桦树过敏原 Bet v1(免疫捕获法,法迪亚,瑞典)的过敏原成分的 IgE。托木斯克地区 7 - 10 岁儿童对花生和榛子的食物过敏患病率分别为 0.08%和 0.09%。对坚果的食物过敏表现出现在学龄前,与坚果过敏相关的主要反应是口腔过敏综合征(75 - 80%)、胃肠道紊乱(60 - 80%)和皮肤瘙痒皮疹(20 - 50%)。对桦树的致敏与对榛子(r = 0.53,p < 0.05)和花生(r = 0.56,p < 0.05)的特异性 IgE 水平显著相关。在食物致敏儿童样本中,对花生热不稳定蛋白 Ara h8(12.3%)和榛子 Cor a1(8.8%)(Bet v1 的同源物)的致敏占主导,这决定了所研究样本中食物致敏形成的交叉反应机制。俄罗斯对花生和榛子的过敏患病率远低于欧洲和北美。对这些食物的致敏是通过与桦树花粉过敏原的交叉反应机制发展而来的。这种致敏类型决定了对榛子和花生过敏的轻度临床症状。

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