Department of Gastroenterology & Hepatology, Academic Medical Center, Amsterdam, the Netherlands; Tytgat Institute for Liver and GI research, Academic Medical Center, Amsterdam, the Netherlands.
Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands.
Gastroenterology. 2018 Jan;154(1):57-60.e2. doi: 10.1053/j.gastro.2017.08.062. Epub 2017 Sep 1.
Skin tests and measurement of serum levels of immunoglobulin E do not accurately identify foods for elimination from the diets of patients with eosinophilic esophagitis (EoE). We investigated whether an esophageal prick test, in which the esophageal mucosa is challenged by local injection of allergen extracts, could identify individuals with esophageal sensitization. During endoscopy, 6 allergens were injected in the esophagus of 8 patients with EoE and 3 patients without EoE (controls). A second endoscopy was performed after 24 hours to evaluate delayed responses. Five of the 8 patients with EoE had evidence for an acute response (luminal obstruction and mucosal blanching); 2 other patients had a delayed wheal or flare reaction. No responses were observed in controls. We conclude that esophageal mucosal food allergen injections induce acute and/or delayed responses in patients with EoE but not controls. The esophageal prick test deserves further exploration because it may guide elimination diets.
皮肤试验和血清免疫球蛋白 E 水平测量不能准确确定食物是否应从嗜酸性食管炎 (EoE) 患者的饮食中消除。我们研究了食管针刺试验是否可以识别食管致敏的个体，在该试验中，通过局部注射过敏原提取物来挑战食管黏膜。在进行内镜检查时，将 6 种过敏原注射到 8 名 EoE 患者和 3 名无 EoE（对照组）患者的食管中。24 小时后进行第二次内镜检查以评估迟发反应。8 名 EoE 患者中有 5 名出现急性反应（管腔阻塞和黏膜苍白）；另外 2 名患者出现迟发性风团或 flare 反应。对照组未见反应。我们得出结论，食管黏膜食物过敏原注射会引起 EoE 患者的急性和/或迟发性反应，但不会引起对照组的反应。食管针刺试验值得进一步探索，因为它可能指导消除饮食。
