Krzych-Fałta Edyta, Wojas Oksana, Samel-Kowalik Piotr, Sybilski Adam J, Samoliński Bolesław
Department Basic of Nursing Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.
Department of Prevention of Environmental Hazards, Allergology and Immunology Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.
Allergy Asthma Clin Immunol. 2022 Jul 1;18(1):59. doi: 10.1186/s13223-022-00700-3.
Allergies, including food allergies, are a considerable clinical and public-health problem. The introduced preventive measures and differential diagnostics, including oral food challenges, are the gold standard for determining further treatment planning.
We present a case of an 18-year-old girl with a cow's milk allergy who underwent an oral food challenge (double blind oral food challenge). Such a challenge may be confounded by inducing a response from other systems and organs, which provides theoretical grounds for the use of other methods of assessing the body's response to food allergens (response demonstrated by the upper respiratory tract). Based on this idea, in order to assess the degree of mucosal response, we used optical rhinometry as an objective method for nasal patency evaluation, as well as identification of tryptase level in nasal lavage fluid and exfoliative cytology of nasal mucosa. The results of these tests confirmed positive reaction of the nasal mucosa in the course of the oral allergen challenge.
The observed increase in the nasal mucosal reactivity that accompanies oral food challenges may suggest a potential for using food allergens in nasal allergen provocation testing in order to diagnose food allergies.
过敏，包括食物过敏，是一个相当严重的临床和公共卫生问题。所采用的预防措施和鉴别诊断方法，包括口服食物激发试验，是确定进一步治疗方案的金标准。
我们报告一例18岁牛奶过敏女孩接受口服食物激发试验（双盲口服食物激发试验）的病例。这种激发试验可能会因诱发其他系统和器官的反应而受到干扰，这为使用其他评估机体对食物过敏原反应的方法（上呼吸道表现出的反应）提供了理论依据。基于这一想法，为了评估黏膜反应程度，我们使用鼻光学测量法作为评估鼻通畅度的客观方法，以及测定鼻灌洗液中类胰蛋白酶水平和鼻黏膜脱落细胞学检查。这些测试结果证实了口服过敏原激发试验过程中鼻黏膜的阳性反应。
口服食物激发试验中观察到的鼻黏膜反应性增加可能表明，在鼻过敏原激发试验中使用食物过敏原诊断食物过敏具有潜力。
