在过敏原测试中发现的过敏现象与抑制剂不响应有关,而这种过敏现象在eosinophilic食道炎中是无反应的
Mayssan Muftah1,2,3, Davis A Hartnett2,3, Ryan Flanagan1,2,3
1Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Journal of gastroenterology and hepatology
|January 7, 2024
概括
对食物过敏呈阳性测试的乳酸性食道炎 (EoE) 患者不太可能对质子抑制剂 (PPI) 治疗产生反应. 过敏测试可以指导针对EoE的个性化治疗策略.
科学领域:
- 胃肠病学 胃肠病学
- 过敏 免疫学 免疫学
背景情况:
- 性食道炎 (EoE) 与食物和环境过敏原有关.
- 在EoE中,过敏特征与对质子抑制剂 (PPI) 的治疗反应之间的关系尚不清楚.
研究的目的:
- 调查食品/环境过敏原测试的阳性结果与新诊断的,未经治疗的EoE患者对PPI治疗的组织学反应之间的关联.
主要方法:
- 新诊断出EoE的成年人接受过敏测试和每天两次PPI的8周疗程.
- 通过重复内镜和活检评估了组织学反应,根据食道中异osinophil 数量 (分别<15或≥15个异osinophil/hpf) 将患者分类为PPI响应者 (PPI-r-EoE) 或非响应者 (PPI-nr-EoE).
主要成果:
- 在61名患者中,21人是PPI反应者,40人是非反应者.
- 阳性食物过敏原测试在PPI不响应者 (82.5%与42.9%,P=0.003) 和独立预测的PPI不响应者 (aOR 0.15) 中明显更常见.
- 虽然积极的环境过敏原测试在两组中都普遍存在,但更多的积极的环境过敏原与PPI无反应相关.
结论:
- 积极的食物过敏测试和更多的环境过敏原与EoE中PPI治疗组织学改善的可能性降低有关.
- 这些发现表明过敏的EoE表型可能对PPI反应较弱.
- 过敏原测试可以为EoE患者提供个性化管理策略.
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