Rojo Gutiérrez María Isabel, Ballesteros González Diego, Ortiz Durán Ana Karen
Alergóloga e Inmunóloga clínica, Máster en Ciencias y Educación; Miembro de la Mesa Directiva de SLAAI; miembro activo del Colegio Mexicano de Inmunología Clínica y Alergia; Directora de Alergología en la Unidad Médica Zúrich, Ciudad de
Médico Cirujano y Partero, Escuela Superior de Medicina, Instituto Politécnico Nacional; Alergia e inmunología clínica, Hospital Juárez de México.
Rev Alerg Mex. 2023 Dec 31;70(4):269-279. doi: 10.29262/ram.v70i4.1338.
Food allergy is an immune response to proteins in food. It usually affects 8% of children and 2% of adults in Western countries. Non-IgE-mediated food allergy mainly affects the gastrointestinal tract. Gastrointestinal food allergies are classified, by their underlying pathogenesis, as: IgE-mediated, non-IgE-mediated, or mixed. The symptoms of patients with food protein-induced allergic proctocolitis originate from local inflammation of the distal colon, which causes hematochezia in neonates. It can affect the entire gastrointestinal tract and cause symptoms of intractable emesis, with subsequent metabolic disorders and hypovolemic shock. Food protein-induced enterocolitis syndrome is a non-IgE-mediated allergy that usually appears in childhood, with prolonged repetitive vomiting, starting 1 to 4 hours after ingestion of food. The manifestation in adults is usually triggered by the consumption of shellfish. Atopic diseases affect 40-60% of patients with food protein- induced enterocolitis syndrome, including 40-50% of those with food protein-induced enteropathy and proctocolitis. Probiotics (Lactobacillus GG) can alleviate the symptoms of allergic proctocolitis induced by food proteins, by altering the composition of the intestinal microbiota. Fecal microbiota transplantation (FMT) can change intestinal microecology efficiently compared to food or probiotics.
食物过敏是对食物中蛋白质的免疫反应。在西方国家，它通常影响8%的儿童和2%的成年人。非IgE介导的食物过敏主要影响胃肠道。胃肠道食物过敏根据其潜在发病机制可分为：IgE介导型、非IgE介导型或混合型。食物蛋白诱导的过敏性直肠结肠炎患者的症状源于远端结肠的局部炎症，这会导致新生儿便血。它可影响整个胃肠道，并引起顽固性呕吐症状，随后出现代谢紊乱和低血容量性休克。食物蛋白诱导的小肠结肠炎综合征是一种非IgE介导的过敏，通常出现在儿童期，摄入食物后1至4小时开始出现长时间反复呕吐。成人的表现通常由食用贝类引发。特应性疾病影响40%至60%的食物蛋白诱导的小肠结肠炎综合征患者，包括40%至50%的食物蛋白诱导的小肠病和直肠结肠炎患者。益生菌（鼠李糖乳杆菌GG）可通过改变肠道微生物群的组成来缓解食物蛋白诱导的过敏性直肠结肠炎的症状。与食物或益生菌相比，粪便微生物群移植（FMT）能更有效地改变肠道微生态。
