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IgE 介导的食物过敏:当前的诊断模式和具有强大潜力的新型生物标志物。

IgE-Mediated food allergy: Current diagnostic modalities and novel biomarkers with robust potential.

机构信息

College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, P.R. China.

出版信息

Crit Rev Food Sci Nutr. 2023;63(29):10148-10172. doi: 10.1080/10408398.2022.2075312. Epub 2022 May 19.

Abstract

Food allergy (FA) is a serious public health issue afflicting millions of people globally, with an estimated prevalence ranging from 1-10%. Management of FA is challenging due to overly restrictive diets and the lack of diagnostic approaches with high accuracy and prediction. Although measurement of serum-specific antibodies combined with patient medical history and skin prick test is a useful diagnostic tool, it is still an imprecise predictor of clinical reactivity with a high false-positive rate. The double-blind placebo-controlled food challenge represents the gold standard for FA diagnosis; however, it requires large healthcare and involves the risk of acute onset of allergic reactions. Improvement in our understanding of the molecular mechanism underlying allergic disease pathology, development of omics-based methods, and advances in bioinformatics have boosted the generation of a number of robust diagnostic biomarkers of FA. In this review, we discuss how traditional diagnostic modalities guide appropriate diagnosis and management of FA in clinical practice, as well as uncover the potential of the latest biomarkers for the diagnosis, monitoring, and prediction of FA. We also raise perspectives for precise and targeted medical intervention to fill the gap in the diagnosis of FA.

摘要

食物过敏(FA)是一个严重的全球公共卫生问题,影响着全球数百万人,其估计患病率在 1-10%之间。由于过度限制饮食以及缺乏准确性和预测性高的诊断方法,FA 的管理具有挑战性。虽然测量血清特异性抗体结合患者病史和皮肤点刺试验是一种有用的诊断工具,但它仍然是临床反应性的不精确预测因子,具有很高的假阳性率。双盲安慰剂对照食物挑战代表 FA 诊断的金标准;然而,它需要大量的医疗保健,并涉及急性过敏反应的风险。我们对过敏疾病病理学基础的分子机制的理解的提高、基于组学方法的发展和生物信息学的进步,推动了大量 FA 的稳健诊断生物标志物的产生。在这篇综述中,我们讨论了传统诊断方式如何指导 FA 的临床实践中的适当诊断和管理,并揭示了最新生物标志物在 FA 的诊断、监测和预测中的潜力。我们还提出了精确和有针对性的医疗干预的观点,以填补 FA 诊断中的空白。

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