Chojnowska-Wójtowicz Magdalena, Łyżwa Klementyna, Zielińska Joanna, Zagórska Wioletta, Grzela Katarzyna
Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
Postepy Dermatol Alergol. 2023 Feb;40(1):40-46. doi: 10.5114/ada.2022.124730. Epub 2023 Feb 27.
The diagnostics of plant-derived food allergy may be challenging. However, the recognition of sensitization patterns in defined populations, especially in children, is clinically relevant as it enables the use of secondary prophylaxis to prevent life-threatening complications.
To investigate the rates and sensitization patterns to nut allergens in children from central Poland.
The retrospective assessment concerned data of 598 children diagnosed in a single centre due to suspected food allergy. The analysis included the results of component-based multiparametric assay Allergy Explorer2 (ALEX2).
The sensitization to particular nut allergens varied among patients, depending on their age and nut type. The sensitization to any nut was found in 67% of children, whereas sensitization to hazelnut and peanut was the most common (56% and 55% of all children, respectively). Hazelnut sensitization was predominant in every age, and its prevalence increased with age, while peanut sensitization was detected in more than half of individuals from all groups, except for teenagers (44% of cases). Among hazelnut molecules sensitization to Cor a 1.04 was the most prevalent (74% of sensitized children), and for peanut allergens - Ara h 1 (65% of sensitized patients). The simultaneous sensitization to hazelnut, peanut and walnut (two or all of them) was found in almost half of the entire group.
Component-based diagnostics enables differentiation between primary and cross-reactive sensitization to nut allergens and detects co-sensitization. The clinical relevance of the latter observation is remarkable as co-sensitization increases the risk of life-threatening reactions even in trace nut contamination.
植物源性食物过敏的诊断可能具有挑战性。然而,识别特定人群,尤其是儿童的致敏模式在临床上具有重要意义,因为它有助于采用二级预防措施来预防危及生命的并发症。
调查波兰中部儿童对坚果过敏原的致敏率和致敏模式。
回顾性评估涉及在单一中心因疑似食物过敏而确诊的598名儿童的数据。分析包括基于组分的多参数检测Allergy Explorer2(ALEX2)的结果。
对特定坚果过敏原的致敏情况因患者年龄和坚果类型而异。67%的儿童对任何坚果致敏,而对榛子和花生的致敏最为常见(分别占所有儿童的56%和55%)。榛子致敏在各年龄段均占主导,且其患病率随年龄增长而增加,而除青少年外(44%的病例),所有组中超过一半的个体检测到花生致敏。在榛子分子中,对Cor a 1.04的致敏最为普遍(74%的致敏儿童),对于花生过敏原——Ara h 1(65%的致敏患者)。几乎一半的整个研究组中发现同时对榛子、花生和核桃致敏(对其中两种或全部三种致敏)。
基于组分的诊断能够区分对坚果过敏原的原发性致敏和交叉反应性致敏,并检测到共同致敏。后一观察结果的临床意义显著,因为即使在微量坚果污染的情况下,共同致敏也会增加危及生命反应的风险。