Mandallaz M M, de Weck A L, Dahinden C A
Institute of Clinical Immunology, Bern University Hospital, Switzerland.
Int Arch Allergy Appl Immunol. 1988;87(2):143-50.
87 adult patients from our allergy clinic were skin tested with budgerigar and canary feathers, hen's egg white and egg yolk and common inhalant allergens. Of 59 patients found to be atopic, 17 (29%) were concomitantly sensitized to bird dander and egg proteins, 10 of them being symptomatic to bird dander and/or egg exposure. All but 1 of the egg-symptomatic patients were exposed to pet birds. The patients with strong serological reactivity to bird antigens were also exclusively sensitized to egg proteins, in particular to livetins (water-soluble fractions of egg-yolk proteins). Extensive RAST-inhibition studies demonstrated identical patterns of cross-reactivity between bird dander and hen's egg proteins, livetins being the major cross-reacting antigens. This peculiar IgE-mediated allergy is designated as 'bird-egg syndrome'. It is suggested that egg intolerance in adults is mainly due to sensitization to egg-yolk livetins and can be provoked by inhalation of pet bird dander. Thus, it must be distinguished from the common egg-white allergy of atopic children. Our study further underlines the importance of respiratory sensitization in adult food allergy. On the other hand, exposure to cross-reacting antigens by ingestion might also influence the allergic manifestations to inhalant allergens.
我们过敏诊所的87名成年患者接受了虎皮鹦鹉和金丝雀羽毛、蛋清和蛋黄以及常见吸入性过敏原的皮肤测试。在59名被发现患有特应性的患者中，17名（29%）同时对鸟类皮屑和鸡蛋蛋白致敏，其中10名对鸟类皮屑和/或接触鸡蛋有症状。除1名对鸡蛋有症状的患者外，其他患者均接触过宠物鸟。对鸟类抗原具有强烈血清学反应性的患者也仅对鸡蛋蛋白致敏，尤其是对livetins（蛋黄蛋白的水溶性部分）。广泛的RAST抑制研究表明，鸟类皮屑和鸡蛋蛋白之间存在相同的交叉反应模式，livetins是主要的交叉反应抗原。这种特殊的IgE介导的过敏被称为“鸟蛋综合征”。研究表明，成年人对鸡蛋不耐受主要是由于对蛋黄livetins致敏，并且可能由吸入宠物鸟皮屑引发。因此，必须将其与特应性儿童常见的蛋清过敏区分开来。我们的研究进一步强调了呼吸道致敏在成人食物过敏中的重要性。另一方面，通过摄入接触交叉反应抗原也可能影响对吸入性过敏原的过敏表现。
