Faculdades Pequeno Príncipe, Pós-Graduação em Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Hospital Pequeno Príncipe, Serviço de Alergia e Imunologia Pediátrica, Curitiba, PR, Brazil; Complexo Hospital de Clinicas - Ebserh, UFPR, Curitiba, PR, Brazil.
Faculdades Pequeno Príncipe, Curso de Medicina, Curitiba, PR, Brazil.
J Pediatr (Rio J). 2023 Jul-Aug;99(4):315-321. doi: 10.1016/j.jped.2023.02.004. Epub 2023 Mar 25.
The prevalence of food allergies (FA) has increased worldwide over the last few decades. Milk, eggs, and peanuts are among the most common allergens and can cause anaphylaxis. Therefore, we aimed to identify biomarkers that could predict the persistence and/or severity of IgE-mediated allergies to milk, eggs, and peanuts via a systematic review.
This systematic review proceeded according to a protocol registered in the International Prospective Register of Systematic Reviews. Two independent authors extracted studies of interest from PubMed, SciELO, EMBASE, Scopus, and Ebsco databases and assessed their quality using the Newcastle-Ottawa Scale.
We selected 14 articles describing 1,398 patients. Among eight identified biomarkers, total IgE, specific IgE (sIgE), and IgG4 were the most often cited biomarkers of persistent allergies to milk, eggs, and peanuts. Skin prick tests, endpoint tests, and sIgE cutoff levels may predict positive responses to challenges with these foods. The basophil activation test is a biomarker for the severity and/or threshold of allergic reactions to milk and peanuts.
Only a few publications identified possible prognostic indicators of the persistence or severity of FA and outcomes of oral food challenges, indicating that more accessible biomarkers are needed to determine the likelihood of having a severe food allergic reaction.
在过去几十年中，全球范围内食物过敏（FA）的患病率有所增加。牛奶、鸡蛋和花生是最常见的过敏原之一，可引起过敏反应。因此，我们旨在通过系统评价确定能够预测 IgE 介导的牛奶、鸡蛋和花生过敏持续存在和/或严重程度的生物标志物。
本系统评价按照在国际前瞻性登记系统评价中注册的方案进行。两名独立作者从 PubMed、SciELO、EMBASE、Scopus 和 Ebsco 数据库中提取感兴趣的研究，并使用纽卡斯尔-渥太华量表评估其质量。
我们选择了描述 1398 名患者的 14 篇文章。在确定的 8 种生物标志物中，总 IgE、特异性 IgE（sIgE）和 IgG4 是牛奶、鸡蛋和花生持续过敏的最常被引用的生物标志物。皮肤点刺试验、终点试验和 sIgE 截断值可能预测对这些食物进行挑战时的阳性反应。嗜碱性粒细胞活化试验是牛奶和花生过敏反应严重程度和/或阈值的生物标志物。
只有少数出版物确定了 FA 持续存在或严重程度以及口服食物挑战结果的可能预后指标，这表明需要更易获得的生物标志物来确定发生严重食物过敏反应的可能性。
