Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, Calif; Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, Calif.
Thermo Fisher Scientific, Immunodiagnostics, Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
J Allergy Clin Immunol Pract. 2017 Sep-Oct;5(5):1325-1334.e4. doi: 10.1016/j.jaip.2017.01.016. Epub 2017 Mar 27.
Thirty percent of children with food allergies have multiple simultaneous allergies; however, the features of these multiple allergies are not well characterized serologically or clinically.
We comprehensively evaluated 60 multifood-allergic patients by measuring serum IgE to key allergen components, evaluating clinical histories and medication use, performing skin tests, and conducting double-blind, placebo-controlled food challenges (DBPCFCs).
Sixty participants with multiple food allergies were characterized by clinical history, DBPCFCs, total IgE, specific IgE, and component-resolved diagnostics (IgE and IgG4) data. The food allergens tested were almond, egg, milk, sesame, peanut, pecan, walnut, hazelnut, cashew, pistachio, soy, and wheat.
Our data demonstrate that of the reactions observed during a graded DBPCFC, gastrointestinal reactions occurred more often in boys than in girls, as well as in individuals with high levels of IgE to 2S albumins from cashew, walnut, and hazelnut. Certain food allergies often occurred concomitantly in individuals (ie, cashew/pistachio and walnut/pecan/hazelnut). IgE testing to components further corroborated serological relationships between and among these clustered food allergies.
Associations of certain food allergies were shown by DBPCFC outcomes as well as by correlations in IgE reactivity to structurally related food allergen components. Each of these criteria independently demonstrated a significant association between allergies to cashew and pistachio, as well as among allergies to walnut, pecan, and hazelnut.
30%的食物过敏儿童同时患有多种过敏症；然而，这些多种过敏症的特征在血清学或临床上尚未得到很好的描述。
我们通过测量关键过敏原成分的血清 IgE、评估临床病史和用药情况、进行皮肤测试以及进行双盲、安慰剂对照食物挑战（DBPCFC），全面评估了 60 名多重食物过敏患者。
通过临床病史、DBPCFC、总 IgE、特异性 IgE 和成分解析诊断（IgE 和 IgG4）数据对 60 名多重食物过敏患者进行了特征描述。测试的食物过敏原包括杏仁、鸡蛋、牛奶、芝麻、花生、山核桃、核桃、榛子、腰果、开心果、大豆和小麦。
我们的数据表明，在逐渐进行的 DBPCFC 中观察到的反应中，胃肠道反应在男孩中比女孩中更常见，在对腰果、核桃和榛子中的 2S 白蛋白 IgE 水平较高的个体中也更常见。某些食物过敏症经常同时发生在个体中（例如，腰果/开心果和核桃/山核桃/榛子）。对成分的 IgE 测试进一步证实了这些聚类食物过敏之间和之间的血清学关系。
DBPCFC 结果以及对结构相关食物过敏原成分的 IgE 反应相关性显示出某些食物过敏症之间的关联。这些标准中的每一个都独立地表明了腰果和开心果过敏之间以及核桃、山核桃和榛子过敏之间存在显著关联。
