Strimas J H, Chi D S
Department of Pediatrics, Louisiana State University Medical School, New Orleans.
Ann Allergy. 1988 Aug;61(2):133-6.
Intrauterine sensitization has been reported in animal and clinical studies. One study suggests that the amniotic fluid (AF) IgE level might be useful in predicting infant allergy. We followed for 1 year 83 newborns on whom we had 78 samples of AF, 82 of cord serum (CS), and 83 of maternal serum (MS). All infants were delivered by C-section at term. Amniotic fluid samples were aspirated through the exposed myometrium. Sanguineous specimens were excluded. Amniotic fluid, CS, and MS were tested for total IgE level and IgE RAST to three foods: cow's milk, egg white, and peanut. Data on family medical history, feeding history, and allergy symptoms were collected for 12 months. By 1 year 23% had probable allergy: recurrent wheezing = 8, food related G.I. symptoms = 7, and atopic dermatitis = 4. Allergy in formula-fed infants occurred more often than in those breast-fed for greater than 6 months. IgE in AF was greater than or equal to 0.5 IU/mL in 21/78 (27%); range = 0.5 to 5.9 and geometric mean = 0.76. No correlation was noted between AF total IgE and the appearance of allergy. RAST was equivocally positive in 1.2% AF. Cord serum total IgE was greater than or equal to 0.5 IU/mL in 6/82 (7%); range = 0.5 to 2.6 and geometric mean = 0.72. Allergy appeared in 67% of infants with CS total IgE greater than or equal to 0.5 IU/mL. RAST was negative in all CS samples. In this limited series, AF IgE did not seem to have predictive value of allergy in infancy.
动物研究和临床研究均已报道过宫内致敏现象。一项研究表明，羊水（AF）免疫球蛋白E（IgE）水平可能有助于预测婴儿过敏。我们对83名新生儿进行了为期1年的随访，共采集了78份羊水样本、82份脐血血清（CS）样本和83份母血血清（MS）样本。所有婴儿均足月剖宫产分娩。通过暴露的子宫肌层抽取羊水样本，排除血性标本。检测羊水、脐血血清和母血血清中的总IgE水平以及针对三种食物（牛奶、蛋清和花生）的IgE放射变应原吸附试验（RAST）。收集12个月的家族病史、喂养史和过敏症状数据。到1岁时，23%的婴儿可能患有过敏：反复喘息8例、食物相关胃肠道症状7例、特应性皮炎4例。配方奶喂养的婴儿比母乳喂养超过6个月的婴儿更容易发生过敏。21/78（27%）的羊水IgE大于或等于0.5 IU/mL；范围为0.5至5.9，几何平均数为0.76。未发现羊水总IgE与过敏表现之间存在相关性。1.2%的羊水样本RAST呈可疑阳性。6/82（7%）的脐血血清总IgE大于或等于0.5 IU/mL；范围为0.5至2.6，几何平均数为0.72。脐血血清总IgE大于或等于0.5 IU/mL的婴儿中，67%出现了过敏症状。所有脐血血清样本的RAST均为阴性。在这个有限的系列研究中，羊水IgE似乎对婴儿期过敏没有预测价值。
