RESUMO
The increase in the prevalence of allergic diseases has brought a substantial medical, social and economic burden. The development of allergology is relatively lag behind the allergy prevalence in China. Both the numbers of allergy specialty and allergist are scarce and thus the diagnosis and treatment of allergic disease does not meet the needs of allergy patients. This article summarizes the status of medical education and specialty development of allergology in China and abroad. In addition, the key strategies for promoting the development of allergy education and specialty were discussed, including undergraduate and graduate education of allergology, the orientation of allergy specialty and related specialty/subspecialty, the integration of allergology into the standardized residents training system, training and certification of allergists, and multidisciplinary diagnosis and treatment model.
Assuntos
Humanos , Hipersensibilidade/terapia , Educação Médica , Educação de Pós-Graduação , China/epidemiologia , EstudantesRESUMO
The increase in the prevalence of allergic diseases has brought a substantial medical, social and economic burden. The development of allergology is relatively lag behind the allergy prevalence in China. Both the numbers of allergy specialty and allergist are scarce and thus the diagnosis and treatment of allergic disease does not meet the needs of allergy patients. This article summarizes the status of medical education and specialty development of allergology in China and abroad. In addition, the key strategies for promoting the development of allergy education and specialty were discussed, including undergraduate and graduate education of allergology, the orientation of allergy specialty and related specialty/subspecialty, the integration of allergology into the standardized residents training system, training and certification of allergists, and multidisciplinary diagnosis and treatment model.
Assuntos
Humanos , Hipersensibilidade/terapia , Educação Médica , Educação de Pós-Graduação , China/epidemiologia , EstudantesRESUMO
There are many types in food allergy, and the most common is mediated by IgE. Currently, the diagnosis of food allergy mainly relied on skin prick test and serum specific IgE of allergen extract, which can not identify cross-sensitization. Component-resolved diagnosis (CRD) can identify the major allergen components and cross-components of food allergens, which plays an important role in dietary guidance, prognosis monitoring and diagnosis of special types of IgE-mediated food allergy. This article enumerates clinical characteristics of the IgE-mediated common food allergies, such as milk, egg and seafood allergy, and special type of food allergy, such as cat pork syndrome, oral allergy syndrome, α-gal syndrome and food-dependent exercise-induced anaphylaxis, summarizes the advances of CRD in these types of IgE-mediated food allergy, in order to provide an evidence for the diagnosis, treatment and prevention of IgE-mediated food allergy.
Assuntos
Humanos , Alérgenos , Imunoglobulina E , Hipersensibilidade Alimentar/diagnóstico , Testes CutâneosRESUMO
Wheat dependent exercise-induced anaphylaxis (WDEIA) is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life (QOL) is unclear. This study characterized the clinical and laboratory features and investigated the QOL in WDEIA patients from Central China. Twenty-eight WDEIA patients were analyzed, and QOL was measured by validated Chinese version Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF) and Food Allergy Independent Measure (FAIM) after obtaining the diagnosis. The results showed that half of the patients were females. The median onset age was 37 years old. The symptoms occurred within 1 h after wheat ingestion (26/28). Symptoms of anaphylaxis included cutaneous (26/28), respiratory (11/28), gastro-intestinal (5/28) and cardiovascular manifestations (27/28). Skin prick tests were positive to salt soluble (89.3%) and salt insoluble wheat allergen extracts (100%). Positive rate to wheat, gluten and omega-5 gliadin specific IgE was 64.3%, 92.9% and 92.9% respectively. Specific IgE to omega-5 gliadin with a cut-off value 0.83 KU/L offered highly efficient diagnostic criterion for WDEIA (sensitivity: 89.3%; and specificity: 88.9%). The mean scores of FAQLQ-AF and FAIM were 4.70 and 4.98 respectively and level of anti-omega-5 gliadin IgE had positive correlations with FAQLQ scores. Thereby, WDEIA is commonly found in mid-age adults. In most cases, multi-organs especially skin and cardiovascular systems are involved. Salt insoluble wheat allergen skin test and serum specific IgE to gluten and omega-5 gliadin help to diagnose WDEIA. QOL in WDEIA patients is severely impaired.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alérgenos , Química , Alergia e Imunologia , Anafilaxia , Diagnóstico , Alergia e Imunologia , Psicologia , China , Exercício Físico , Trato Gastrointestinal , Alergia e Imunologia , Gliadina , Química , Alergia e Imunologia , Coração , Imunoglobulina E , Sangue , Pulmão , Alergia e Imunologia , Qualidade de Vida , Pele , Alergia e Imunologia , Testes Cutâneos , Inquéritos e Questionários , Triticum , Química , Alergia e Imunologia , Hipersensibilidade a Trigo , Diagnóstico , Alergia e Imunologia , PsicologiaRESUMO
<p><b>OBJECTIVE</b>To study the genera and seasonal distribution of airborne pollen in Hubei province of China, and its relationship with pollinosis.</p><p><b>METHODS</b>From November 2003 to October 2004, an airborne pollen investigation was performed in 16 chosen areas in 12 cities of Hubei province using gravity sedimentation technique. Meanwhile, univalent skin prick tests of pollens were performed and the invasion season was studied on 2,300 patients with pollinosis. Among them, 352 cases underwent the airway responsiveness measurements, and the correlation between airway responsiveness and results of pollen count was analyzed.</p><p><b>RESULTS</b>A total of 61 pollen genera were observed and 257,520 pollens were collected. The peak of airborne pollen distribution occurred in two seasons each year: spring (March and April) and autumn (from August to October). The attack of pollinosis corresponded to the peak of pollen distribution. There was a significantly negative relationship between the provocation dose causing a 20% decrease of forced expiratory volume in one second (FEV1) from baseline and airborne pollen concentration (r= -0.6829, P < 0.05).</p><p><b>CONCLUSION</b>This study provides useful information for airborne pollen epidemiology of Hubei province, and it provides important insights to clinical prevention, diagnosis, and treatment of pollen-related allergic diseases.</p>