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[组分解析诊断:提高贝类过敏的精准诊断与临床管理]

[Component-resolved diagnosis: enhancing precision diagnosis and clinical management of shellfish allergies].

作者信息

Zhang J L, Luo W T, Li A L, Sun B Q

机构信息

Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Sep 6;58(9):1485-1492. doi: 10.3760/cma.j.cn112150-20240613-00470.

Abstract

Shellfish, being one of the eight major food allergens, affects approximately 3% of the global population. The occurrence of shellfish allergy is not only related to the individual's immune system sensitivity but is also influenced by geographical environment, food availability, and dietary habits. Although crustaceans (such as shrimp, crab, and lobster) and mollusks (such as oysters, mussels, and squid) are collectively referred to as shellfish, they exhibit significant differences in biological evolution and the spectrum of allergenic molecules they contain, leading to various allergic reactions. Accurate identification of allergenic proteins is crucial for the diagnosis and management of shellfish allergies, with key allergenic protein families including tropomyosin, arginine kinase, and hemocyanin. Furthermore, due to the diversity of shellfish allergens and their cross-reactivity with dust mite and insect allergens, diagnosing and managing shellfish allergies is complex, especially concerning tropomyosin and arginine kinase protein families. Currently, there are no specific immunotherapy treatments for shellfish allergies, and clinical management primarily relies on avoiding allergens and using anti-allergy medications. This article thoroughly interprets the " Molecular Allergology User's Guide 2.0 (MAUG 2.0)" published by the European Academy of Allergy and Clinical Immunology (EAACI) and the latest research on shellfish allergies both domestically and internationally. It highlights the significant role of allergen component diagnostics in optimizing the diagnostic and treatment processes for shellfish allergies, effectively assisting clinicians in accurately identifying common allergens and cross-reactions, thereby providing patients with more personalized diagnosis and treatment plans.

摘要

贝类作为八大主要食物过敏原之一,影响着全球约3%的人口。贝类过敏的发生不仅与个体免疫系统的敏感性有关,还受到地理环境、食物供应和饮食习惯的影响。尽管甲壳类动物(如虾、蟹和龙虾)和软体动物(如牡蛎、贻贝和鱿鱼)统称为贝类,但它们在生物进化以及所含过敏原分子谱方面存在显著差异,从而导致各种过敏反应。准确识别过敏原蛋白对于贝类过敏的诊断和管理至关重要,关键的过敏原蛋白家族包括原肌球蛋白、精氨酸激酶和血蓝蛋白。此外,由于贝类过敏原的多样性及其与尘螨和昆虫过敏原的交叉反应性,贝类过敏的诊断和管理较为复杂,尤其是涉及原肌球蛋白和精氨酸激酶蛋白家族。目前,尚无针对贝类过敏的特异性免疫疗法,临床管理主要依靠避免接触过敏原和使用抗过敏药物。本文深入解读了欧洲变态反应和临床免疫学会(EAACI)发布的《分子变态反应学用户指南2.0(MAUG 2.0)》以及国内外关于贝类过敏的最新研究。它强调了过敏原成分诊断在优化贝类过敏诊断和治疗过程中的重要作用,有效协助临床医生准确识别常见过敏原和交叉反应,从而为患者提供更个性化的诊断和治疗方案。

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