Beyer K, Niggemann B, Schulze S, Wahn U
University Children's Hospital, Berlin, Germany.
Int Arch Allergy Immunol. 1994 Aug;104(4):348-51. doi: 10.1159/000236690.
To study the usefulness of urinary 1-methylhistamine and serum tryptase concentration as monitoring parameters in clinical settings, we investigated 32 children with atopic dermatitis and suspected food allergy during oral food challenges with eggs and cow's milk. Urinary 1-methylhistamine (MH) excretion increased significantly within 1 h after positive oral food challenges (p < 0.006), but showed considerable variation in negative challenges. MH seems to be a sensitive parameter (92.8%), but its specificity is insufficient (37.7%). In the group of 16 positive oral food challenges serum tryptase concentration increased significantly (p < 0.02) directly after provocation and remained elevated up to 2 h after provocation. No variation was observed in negative challenges or nonatopic controls. Serum tryptase concentration seems to be specific for marked clinical reactions after oral food challenges (100%), but its sensitivity was low (25%) and not superior to evaluation by clinical means. We conclude that, despite positive results for the group of children, MH and serum tryptase concentrations are not useful parameters for monitoring oral food challenges in an individual child due to insufficient sensitivity and specificity.
为研究尿中1 - 甲基组胺和血清类胰蛋白酶浓度作为临床监测参数的实用性，我们对32名患有特应性皮炎且怀疑有食物过敏的儿童在进行鸡蛋和牛奶口服食物激发试验期间进行了调查。口服食物激发试验阳性后1小时内，尿中1 - 甲基组胺（MH）排泄量显著增加（p < 0.006），但在激发试验阴性时显示出相当大的变异性。MH似乎是一个敏感参数（92.8%），但其特异性不足（37.7%）。在16次口服食物激发试验阳性的组中，激发试验后血清类胰蛋白酶浓度立即显著增加（p < 0.02），并在激发试验后2小时内一直保持升高。在激发试验阴性组或非特应性对照组中未观察到变化。血清类胰蛋白酶浓度似乎对口服食物激发试验后明显的临床反应具有特异性（100%），但其敏感性较低（25%），且不比临床评估更具优势。我们得出结论，尽管对儿童组有阳性结果，但由于敏感性和特异性不足，MH和血清类胰蛋白酶浓度并非监测个体儿童口服食物激发试验的有用参数。
