低剂量口服食品挑战后小麦过敏儿童的三年预后
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Updated: Jul 4, 2025
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Basophil Activation Test for Allergy Diagnosis
Published on: May 31, 2021
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Takaaki Itonaga1, Noriyuki Yanagida2, Ken-Ichi Nagakura2
1Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan; Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
概括
低剂量口服食品挑战 (LD-OFC) 帮助小麦过敏患者避免排泄. 许多最初有反应性的儿童在三年内就能达到耐受性,这证明了这种方法的有效性.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 儿科胃肠病学 儿科胃肠病学
- 临床营养学 临床营养学
背景情况:
- 低剂量口服食物挑战 (LD-OFC) 是一种预防高风险小麦过敏 (WA) 患者完全消除食物的策略.
- 这项研究调查了接受LD-OFC的患者的3年预后,区分了通过者和失败者.
研究的目的:
- 评估小麦过敏儿童中低剂量口服食品的长期结果.
- 为了确定小麦耐受性获得的速度和避免LD-OFC后完全消除.
主要方法:
- 年龄在6岁以下的患有即时型WA的儿童接受了基线LD-OFC,服用52毫克小麦蛋白.
- 成功完成者每3-6个月升高剂量 (390,1300,5200毫克);失败者每6-12个月重复LD-OFC.
- 麦子耐受性被定义为在3年内无症状摄入5200毫克的麦子蛋白,后基线LD-OFC.
主要成果:
- 在124名儿童中,57%通过了基线LD-OFC (LD-耐受性),43%失败 (LD-反应性).
- 在3年内,38%的LD反应组通过了重新挑战,70%的参与者避免了完全消除小麦.
- 与LD反应组相比,对较高的小麦剂量 (390 mg,1300 mg,5200 mg) 的耐受性达到显著更高的LD耐受性患者百分比 (p < 0.001).
结论:
- 通过初始LD-OFC的患者经常在三年内获得持续的小麦耐受性.
- 大约三分之一的最初LD-OFC阳性 (LD-reactive) 儿童可以在三年内通过重新挑战,这表明有发展耐受性的潜力.
- 高龄,较高的 ω-5-gliadin 特定IgE水平和同时存在的食物过敏是对LD耐受性儿童持续小麦过敏的预测因素.
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