Department of Pediatrics, Division of Allergy Immunology, Icahn School of Medicine at Mount Sinai, Jaffe Food Allergy Institute, One Gustave L. Levy Place, Box 1198, New York, NY 10029, USA.
Expert Rev Mol Diagn. 2015;15(7):895-906. doi: 10.1586/14737159.2015.1041927. Epub 2015 May 15.
Hen's egg allergy affects up to 2.5% of young children and is potentially life-threatening. Several phenotypes of egg allergy have been identified, including those who tolerate extensively heated egg in bakery products. Diagnosis and monitoring for resolution often requires oral food challenges, which can result in anaphylaxis. Newer approaches, such as component-resolved diagnostics, microarray analysis and epitope mapping, are being evaluated to determine if these strategies can replace or reduce the need for oral food challenges. Studies suggest that elevated levels of ovomucoid IgE indicate an inability to tolerate extensively heated forms of egg. Egg protein-specific IgE/IgG4 ratios may be helpful in predicting tolerance. Additionally, patients with conformational epitopes to hen's egg are more likely to resolve their allergy compared with those with IgE binding to sequential epitopes. The pairing of microarray technology to epitope mapping is a potential tool to improve diagnosis. This review examines the current body of literature on these tools.
鸡蛋过敏影响多达 2.5%的幼儿，并且可能具有生命威胁。已经确定了几种鸡蛋过敏表型，包括那些能耐受在烘焙产品中经过充分加热的鸡蛋的人群。为了确定是否能耐受经过充分加热的鸡蛋，通常需要进行口服食物激发试验来进行诊断和监测，但是这可能导致过敏反应。正在评估新的方法，如成分解析诊断、微阵列分析和表位作图，以确定这些策略是否可以替代或减少对口服食物激发试验的需求。研究表明，卵类黏蛋白 IgE 水平升高表明无法耐受经过充分加热的鸡蛋。鸡蛋蛋白特异性 IgE/IgG4 比值可能有助于预测耐受性。此外，与 IgE 结合于顺序表位的患者相比，对鸡卵具有构象表位的患者更有可能解决其过敏问题。微阵列技术与表位作图的结合是一种提高诊断准确性的潜在工具。本综述检查了这些工具的现有文献。
