Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
J Allergy Clin Immunol Pract. 2018 Nov-Dec;6(6):1813-1823. doi: 10.1016/j.jaip.2018.08.010. Epub 2018 Aug 29.
Secondary food allergies due to cross-reactivity between inhalant and food allergens are a significant and increasing global health issue. Cross-reactive food allergies predominantly involve plant-derived foods resulting from a prior sensitization to cross-reactive components present in pollen (grass, tree, weeds) and natural rubber latex. Also, primary sensitization to allergens present in fungi, insects, and both nonmammalian and mammalian meat might induce cross-reactive food allergic syndromes. Correct diagnosis of these associated food allergies is not always straightforward and can pose a difficult challenge. As a matter of fact, cross-reactive allergens might hamper food allergy diagnosis, as they can cause clinically irrelevant positive tests to cross-reacting foods that are safely consumed. This review summarizes the most relevant cross-reactivity syndromes between inhalant and food allergens. Particular focus is paid to the potential and limitations of confirmatory testing such as skin testing, specific IgE assays, molecular diagnosis, and basophil activation test.
由于吸入性过敏原和食物过敏原之间的交叉反应引起的次要食物过敏是一个重大且日益严重的全球健康问题。交叉反应性食物过敏主要涉及植物源性食物，其原因是先前对花粉（草、树、杂草）和天然橡胶乳胶中存在的交叉反应性成分敏感。此外，对真菌、昆虫以及非哺乳动物和哺乳动物肉中存在的过敏原的初次致敏也可能引发交叉反应性食物过敏综合征。这些相关食物过敏的正确诊断并不总是那么简单，可能会带来困难的挑战。事实上，交叉反应性过敏原可能会阻碍食物过敏的诊断，因为它们会导致与安全食用的交叉反应性食物相关的临床无关的阳性测试。这篇综述总结了吸入性过敏原和食物过敏原之间最相关的交叉反应综合征。特别关注皮肤测试、特异性 IgE 检测、分子诊断和嗜碱性粒细胞活化试验等确认性检测的潜在和局限性。
