Meglio P, Farinella F, Trogolo E, Giampietro P G, Cantani A, Businco L
Department of Pediatrics, University La Sapienza, Rome, Italy.
Allerg Immunol (Paris). 1988 Feb;20(2):57-62.
It has been shown that atopic dermatitis improves in children when certain foods are eliminated from the diet. Because of the unreliability of the history and the low sensibility of the total and specific IgE and skin tests, at present the elimination-provocation test is the most definitive means to establish which are the offending food(s). Although many authors claim that reactions following the challenge test in atopic dermatitis are only of the delayed type, others assert that immediate reactions are frequent and can sometimes threaten life. The pathogenesis of such reactions is not yet completely understood. However, it has been suggested that a direct IgE-mediated mechanism, inducing a release of anaphylactic mediators, could play some role. The aim of our study is to investigate the incidence of immediate reactions which can follow the food challenge in children with atopic dermatitis who have never experienced such reactions and, in addition, to investigate the reliability of total and specific IgE and skin tests in predicting immediate reactions after the challenge test. Our preliminary data indicate that immediate reactions following food challenge are frequent. Moreover they can be severe and cannot be predicted by the history, by the total and specific IgE levels and by the skin tests' results.
研究表明，当从饮食中剔除某些食物时，儿童特应性皮炎的症状会有所改善。由于病史的不可靠性以及总IgE、特异性IgE和皮肤试验的低敏感性，目前排除激发试验是确定致病食物的最具决定性的方法。尽管许多作者声称特应性皮炎激发试验后的反应仅为迟发型，但也有其他人断言速发型反应很常见，有时甚至会危及生命。此类反应的发病机制尚未完全明了。然而，有人提出直接的IgE介导机制，诱导过敏介质释放，可能起了一定作用。我们研究的目的是调查在从未经历过此类反应的特应性皮炎儿童中，食物激发试验后速发型反应的发生率，此外，还要调查总IgE、特异性IgE和皮肤试验在预测激发试验后速发型反应方面的可靠性。我们的初步数据表明，食物激发试验后的速发型反应很常见。此外，它们可能很严重，无法通过病史、总IgE和特异性IgE水平以及皮肤试验结果来预测。
