ABSTRACT
The immune mechanism of non-IgE-mediated food allergy is quite complex.Due to the lack of specific laboratory indicators and limited diagnosis and treatment methods, non-IgE-mediated food allergy is usually misdiagnosed.Therefore, it is urgent to clarify the pathogenesis of the disease and search for specific biomarkers and novel therapeutic targets.This review aims to summarize current research results on the immune mechanism of non-IgE-mediated food allergy from two aspects, including the specific immunity and innate immunity, and to explore the potential diagnostic markers.The results may provide novel ideas for effective therapeutic strategies of non-IgE-mediated food allergy.
ABSTRACT
Objective:To discuss the safety of oral food challenge test(OFC).Methods:Clinical data of 120 cases with allergic reactions during OFC in Department of Pediatrics, Peking University Third Hospital from October 2015 to October 2019 were retrospectively analyzed.The relationship between sex, type of allergic foods, type of allergic reactions, involved organ system, serum specific IgE and severe allergic reaction were analyzed.Results:Allergic reactions occurred in 120 cases.There were 95 males and 25 females.The age ranged from 2 months to 10 years.All involved allergens included milk protein(47.5%, 57/120 cases), egg white(22.5%, 27/120 cases), wheat(19.2%, 23/120 cases), peanut(6.7%, 8/120 cases), nut(1.7%, 2/120 cases), and others(2.5%, 3/120 cases). The type of allergic reaction: 107 cases (90.8%) of hypersensitivity reaction occurred, with 24 cases (21.7%) of severe hypersensitivity reaction, and 13 cases (9.2%) of delayed hypersensitivity reaction.The involved systems include skin and mucous membrane, respiratory system, cardiovascular system, digestive system and nervous system.The correlation coefficient between serum specific IgE and severe allergic reaction was 0.315.Conclusions:Children with indications of OFC in the admission hospital have a high risk of OFC allergic reaction.Nearly 90% of them are immediate hypersensiti-vities, even anaphylaxis.Anaphylaxis that is caused by OFC and may lead to life risk or even death should be avoided.
ABSTRACT
Oral food challenge test (OFC) is necessary for the diagnosis of food allergies, however, this clinical diagnosis method has not been popularized yet in China.Although OFC is very important, the knowledge of it is very insufficient and even biased, which is the root cause of non-standard diagnosis of food allergy and over-dependence on allergen testing.Therefore, the necessity, safety, experiment design and results interpretation of OFC would be elucidated in this paper in order to improve the understanding of OFC.
ABSTRACT
PURPOSE: Because the true prevalence of food allergy (FA), as based on the results of an oral food challenge test (OFC), is unknown, it is likely that children with suspected FA unnecessarily eliminate potentially causative foods. This study aimed to identify the prevalence of FA and to determine the proportion of children who unnecessarily eliminate food. METHODS: To identify children with FA, a primary survey was conducted via a questionnaire with all children aged 0-18 years in Niijima village (remote islands of Japan). In the secondary survey, a detailed medical interview was conducted by doctors with children who currently did not eat some foods. The third survey involved serum food-specific immunoglobulin E (IgE) tests and an OFC for children with suspected FA. RESULTS: Of 376 enrolled children, 374 (99.5%) completed the questionnaire. Some foods were eliminated by 18.6% and 13.0% of all children and those ≥6 years old, respectively. The target population for the secondary survey included 69 children who all completed the medical interview. The target population for the third survey consisted of 35 children, of whom 26 (74.3%) underwent the blood test. An OFC was performed 35 times with 20 children. As a result, the prevalence of FA was 4.9% in children of all ages and 4.7% in those ≥6 years old. Moreover, 55.0% children were able to cease eliminating food intake. CONCLUSIONS: It is possible that a considerable number of children unnecessarily eliminate food because of suspected FA.
Subject(s)
Child , Humans , Eating , Epidemiology , Food Hypersensitivity , Health Services Needs and Demand , Hematologic Tests , Immunoglobulin E , Immunoglobulins , Islands , PrevalenceABSTRACT
Cow's milk is a prime offender, causing gastro-intestinal, skin and airway symptoms in infancy. It remains a major cause of allergy in early childhood, while allergy to milk is rare in adulthood. Milk allergy (MA) is one of the causes of atopic dermatitis, acute urticaria, reactions of the gastrointestinal tract, and acute systemic anaphylaxis. However its role in asthma appears to be less clear. The prevalence and incidence of the subjects with milk-induced wheezing have not been well studied. In addition, the number of subjects with proven food-induced wheezing by double-blind, placebo-controlled oral food challenge has been small. Wheezing has been considered unusual in food-hypersensitive subjects, and wheezing as the unique symptom of MA being rare. We experienced one case of asthma caused by MA. It was confirmed by skin prick test and open oral food challenge test in a 34-month-old child who suffered from frequent asthma attack after ingestion of milk. The patient has been treated successfully with the elimination of milk and antiallergic drug. So we report with a brief review and its related literatures.