Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland.
Department of Pediatrics, Oncology, Hematology and Diabetes, Medical University of Lodz, Lodz, Poland.
Allergy Asthma Immunol Res. 2015 Nov;7(6):547-56. doi: 10.4168/aair.2015.7.6.547. Epub 2015 Jun 5.
Recent studies indirectly suggest a possible link between food allergy (FA) and asthma. Most of them have evaluated the occurrence of FA in asthmatic children, especially in the first year of life, using questionnaire-based studies or specific IgE (sIgE) assay. The aim of this study was to evaluate the prevalence and clinical impact of IgE-mediated FA in school children with asthma using a double-blind placebo-controlled food challenge (DBPCFC).
The study group consisted of school children with atopic asthma who were admitted to the Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, for the evaluation of food hypersensitivity. The diagnosis of FA was established using questionnaires, sIgE analysis, and the DBPCFC. Asthma severity and asthma control state were also assessed.
A relationship between consumed food and complaints was reported in 180 children (49.7%). Seventy children (19.3%) were sensitized to food allergens. IgE-mediated FA was confirmed in 24 children (6.6%), while 11 children (3%) demonstrated respiratory symptoms. Food-induced asthma exacerbations were observed in 9 patients (2.5%). Statistically significant differences in the prevalence of atopic dermatitis (P<0.002), urticaria (P<0.03), digestive symptoms (P<0.03), rhinitis (P<0.02), sIgE level (P<0.001), positive family history of atopy (P<0.001) and FA in history (P<0.001) were found between asthmatic children with FA and those without. Children with food-induced asthma exacerbations demonstrated significantly greater severity, poorer controls, and worse morbidity compared to those without.
Although food-induced respiratory reactions in children with asthma were rare, they were classified as severe and associated with worse morbidity, greater severity, and poorer control. As the most commonly observed symptoms were coughing and rhinitis, which can be easily misdiagnosed, a proper diagnosis is essential for improving the management of both clinical conditions.
最近的研究间接表明食物过敏（FA）和哮喘之间可能存在联系。其中大多数研究评估了哮喘儿童，尤其是生命第一年的 FA 发生率，采用基于问卷的研究或特异性 IgE（sIgE）检测。本研究旨在通过双盲安慰剂对照食物挑战（DBPCFC）评估患有哮喘的学龄儿童中 IgE 介导的 FA 的患病率和临床影响。
研究组由因食物过敏评估而入住罗兹医科大学儿科过敏、胃肠病学和营养科的特应性哮喘学龄儿童组成。FA 的诊断通过问卷调查、sIgE 分析和 DBPCFC 建立。还评估了哮喘严重程度和哮喘控制状态。
180 名儿童（49.7%）报告了食用食物与症状之间的关系。70 名儿童（19.3%）对食物过敏原敏感。24 名儿童（6.6%）被证实存在 IgE 介导的 FA，而 11 名儿童（3%）出现了呼吸道症状。9 名患者（2.5%）出现了食物诱发的哮喘加重。在特应性皮炎（P<0.002）、荨麻疹（P<0.03）、消化道症状（P<0.03）、鼻炎（P<0.02）、sIgE 水平（P<0.001）、特应性阳性家族史（P<0.001）和 FA 史（P<0.001）方面，FA 阳性的哮喘儿童与 FA 阴性的哮喘儿童之间存在统计学显著差异。与无食物诱发哮喘加重的儿童相比，有食物诱发哮喘加重的儿童哮喘严重程度更高，控制更差，发病率更高。
尽管哮喘儿童中食物诱发的呼吸道反应很少见，但它们被归类为严重反应，并与更高的发病率、更高的严重程度和更差的控制相关。由于最常见的症状是咳嗽和鼻炎，这些症状容易误诊，因此进行适当的诊断对于改善这两种临床疾病的管理至关重要。
