Multi-Test Ⅱ点刺器在儿童过敏原皮肤点刺试验中的应用评价

目的 初步评价Multi-Test Ⅱ点刺器在儿童过敏原皮肤点刺试验（SPT）中的适用性。方法 选取2017年3~9月就诊的87例过敏性疾病患儿为研究对象，均进行6种吸入性过敏原的SPT和血清特异性IgE（sIgE）测定。分别应用单点刺针及Multi-Test Ⅱ点刺器于患儿左、右前臂进行SPT的测定，应用荧光酶联免疫法进行血清sIgE浓度的测定。用视觉模拟评分（VAS）标尺评估患儿接受SPT的疼痛程度。比较3种方法6种过敏原的阳性检出率分布差异及Multi-Test Ⅱ点刺器的灵敏度和特异度。结果 Multi-Test Ⅱ法、单点刺针法、荧光酶联免疫法3种方法检出6种过敏原的阳性率比较差异无统计学意义（P > 0.05）。与单点刺针法比较，Multi-Test Ⅱ法灵敏度为72.7%，特异度为78.2%；与荧光酶联免疫法比较，Multi-Test Ⅱ法灵敏度为73.4%、特异度为77.5%。Multi-Test Ⅱ法较单点刺针法疼痛程度低，差异有统计学意义（P < 0.05）。结论 Multi-Test Ⅱ法灵敏度及特异度较高且易被患儿接受，但测定结果需同时与患儿的临床病史相结合，必要时结合血清特异性IgE测定结果。     

Associations between atopic markers in asthma and intestinal helminth infections in Cuban schoolchildren

Total serum IgE (tIgE), allergen-specific IgE (sIgE), and skin prick test (SPT) are commonly used markers for atopy and atopic disease. The association between these measures and their relationship to clinical symptoms differs in affluent and non-affluent countries. We investigated the role of intestinal helminth infections in observed variations in atopic markers and asthma, and possible diagnostic and epidemiological consequences. A cross-sectional study was conducted in Cuban schoolchildren (n = 1285; 4-14 yrs). Atopy was determined by SPT, sIgE, and tIgE; asthma by International Study of Asthma and Allergies in Childhood questionnaire; and intestinal helminth infections by stool examination. Percentages of tIgE, sIgE, and SPT positives were 88.9%, 25.5%, and 16.5%, respectively. Asthma was found in 20.8%, and helminth infections in 20.9% of the children. All three atopic markers were significantly associated with each other and with asthma. Median tIgE levels were higher in helminth-infected than in uninfected children, irrespective of their status of atopy/asthma. Discordant results between SPT and sIgE were observed in 22.6% of the children. Among SPT positives, 41% were sIgE negative. The proportion of SPT negatives among sIgE positives was 74% in helminth-infected and 58.4% in uninfected children (p < 0.05). Helminth infections affected tIgE levels, reconfirming the limited value of tIgE for diagnosis of atopy and asthma in tropical areas. Higher frequencies of sIgE than positive SPTs were observed, especially in helminth-infected children. This corresponds with current hypothesis on the role of helminths in atopy. However, the observed proportion of sIgE negatives among children with positive SPT suggests that other mechanisms may also be involved.     

Comparison between serial skin-prick tests and specific serum immunoglobulin E to mite allergens

Sensitization to dust mite allergens can be determined by means of a skin-prick test (SPT) or by measurement of specific IgE antibodies in serum (sIgE). In our study, concordance of the results of both methods was analyzed on the basis of reproducible SPT results. Three consecutive SPTs were performed on 138 school children (age 6–8 years) at one-year intervals. SIgE was determined at the end of a two-year observation period. Seven common inhalant allergens (Dpt, Df, birch pollens, hazel pollens, grass pollens and cat and dog dander) were analyzed. The majority of subjects with positive SPT reactions to the respective allergen also showed sIgE (Dpt: 82/86; Df: 53/53; cat dander: 31/32; dog dander: 6/9; birch pollens: 29/31; hazel pollens: 22/22; grass pollens: 37/37). A significant correlation between the SPT [weal diameter (P₁) or allergen/histamine ratio (P₂)] and sIgE was found for Dpt (P₁ = 0.004/P₂ = 0.016), birch pollens (P₁ = 0.002/P₂ = 0.0001) and grass pollens (P₁ = 0.0005/P₂ = 0.0001). There was also a significant correlation between sIgE to Dpt and to either Der p 1 (p = 0.0001) or Der p 2 (p = 0.0001), as well as between sIgE of both major allergens (p = 0.0001). In the analysis of co-sensitization of Dpt and Df, most subjects sensitized to Dpt were also sensitized to Df (57/91). Children with sIgE to Dpt (n = 87) usually showed sIgE to Df (n = 83). In this study, SPT and sIgE results are concordant and appear equivalent when using reproducible SPTs. Therefore, in the case of a positive Dpt result, additional testing for sensitization to Df can be regarded as redundant when Dpt and Df are the major contributors to the allergen content of house dust.     

温州地区402例哮喘患儿特应质现象分析

目的 对温州地区15岁以下哮喘患儿特应质现象进行分析,探讨其临床及理论价值.方法 回顾性分析402例哮喘患儿皮肤过敏原诊断试验、血清特异性IgE、总IgE、个人过敏史、家族史、过敏原检出率、类型及与年龄关系.结果 哮喘发病有家族聚集倾向,家族过敏史总阳性率为52.74%.个人过敏史总阳性率为61.69%.过敏原皮肤诊断试验和过敏原血清特异IgE阳性率达83.58%,吸人性过敏原阳性人数占检测患儿的74.13%,其中以粉尘螨(61.44%)、屋尘螨(58.96%)为主;食人性过敏原阳性占24.38%,以小虾(16.67%)、牛奶(8.46%)为主.血清总IgE阳性率87.9%,总IgE阳性组和阴性组的哮喘患儿血清嗜酸性细胞阳离子蛋白(ECP)、户尘螨sIgE(D1)、粉尘螨sIgE(D2),皮肤过敏原诊断试验(pt)、家族过敏史、个人过敏史差异有统计学意义(P均≤0.05).哮喘患儿3岁前、后过敏原分布不同,3岁以后吸人性过敏原阳性为主.发病诱因中以上呼吸道感染为最多,哮喘症状发作的时间主要集中在临睡、夜晚、清晨.结论 儿童哮喘存在明显特应质现象,对其的正确认识和诊断对哮喘免疫机制的深入研究、综合治疗如在糖皮质激素吸入治疗的基础上,增加患儿教育、过敏原避免、特异性的免疫治疗等具有实用和理论指导意义.     

Comparison of ADVIA Centaur® and Pharmacia UniCAP® tests in the diagnosis of food allergy in children with atopic dermatitis

In a study comprising 63 children diagnosed with atopic dermatitis, the results of the ADVIA Centaur system was compared with the results obtained with the Pharmacia UniCAP100 system, which has been widely considered as a reference method for seric specific IgE (sIgE) measurements. The individual immunization against the most common food allergens [egg (f1), cow milk (f2), cod (f3), wheat (f4), peanut (f13) and soy bean (f14)] was determined by in vitro serum IgE testing and skin prick test (SPT). The comparison of the sIgE titers revealed a good concordance between the Centaur and the UniCAP tests for f1, f3, and f13 (94 %, 91 %, and 96 % respectively). However, the concordance was lower for f2, f4, and f14 (76 %, 77 %, and 77 % respectively) because of discrepancies between the two techniques. When compared with SPT and clinical diagnosis, on the 40 discordant cases found between the Centaur and the UniCAP, the Centaur showed concordance with the patients food reaction and SPT in 34/40 cases, and UniCAP in only 6/40 cases. Accordingly, the Centaur test displayed a statistically significantly better performance on specificity and concordance with SPT for f2, f4, and f14 (concordance/specificity = 70%/71%, 76%/75% and 90%/88% respectively), than the CAP test (49%/54%, 51%/52% and 67%/65% respectively).     

Effects of maternal dietary avoidance during lactation on allergy in children at 10 years of age

This study investigated the long-term effects of maternal dietary avoidance during lactation on the occurrence of atopic symptoms, development of immunoglobulin E (IgE) antibodies to food and inhaled allergens and occurrence of positive skin-prick tests (SPT) in 65 children with a family history of atopy whose mothers adhered to a diet devoid of eggs, cow's milk and fish during the first 3 months of lactation (D group) and in a matched group of 50 children with mothers not practising such a diet (ND group). The diets of the D and ND children were similar. All children attended 7 follow-ups from the age of 3 months to the age of 10 y. After the first follow-up there was a 100% retention of participants. The results of the seventh follow-up at 10 y are presented. Total IgE values and IgE antibodies to seven food and seven inhaled allergens were determined by the Phadebas IgE CAP^® and the Phadebas RAST^®, respectively. SPT were conducted for five food and seven inhaled allergens. High rates of atopic symptoms occurred in both groups, but there were no differences between the groups. Sensitization to the three foods avoided by the mothers during lactation was similar, but the overall test reactivity to foods was lower in the D group. Sensitization to inhaled allergens was similar in the two groups. During the 10 y of follow-up, there was no difference between the groups in the occurrence of indoor furred animals, tobacco smoking, changes in heredity for atopy or development of total IgE, but a higher rate of maternal sensitization was found in the ND group, as judged by a screening test for IgE antibodies to inhalants (Phadiatop^®). The results do not support general recommendations to implement prophylactic maternal dietary avoidance during lactation in allergy-prone families.     

血清特应性变应原及总IgE抗体与抽动障碍发病的关系

目的抽动障碍(TD)病因尚不明确,通过对TD患儿血清总IgE及特应性变应原IgE进行检测,探讨TD与过敏反应的关系。方法本研究对62例TD患儿进行血清总IgE抗体和特应性变应原检测。收集TD患儿静脉血3 mL,采用欧蒙医学实验诊断股份公司的特应性变应原中国组合3检测试剂盒(欧蒙印迹法)进行总IgE抗体、吸入性和食物变应原特异性IgE抗体(sIgE)检测。结果本研究中TD患儿90.32%以眨眼、挤眼等眼部表现和鼻咽部抽动症状起病。患TD儿童血清总IgE抗体阳性者52例,阳性率为83.87%。血清特异性变应原sIgE检测阳性44例,阳性率为70.97%。吸入性变应原sIgE阳性率高于食物变应原,TD患儿常见变应原有屋尘、树组合(榆树/梧桐树/柳树/杨树/柏树)、尘螨组合(屋尘螨/粉尘螨)、牛奶/巧克力混合、海鲜组合(蟹,扇贝,虾,蛤)。总IgE等级分布与病程长短无关。结论血清特应性变应原及高总IgE抗体可能是引起TD的一个重要原因。     

Epidemiology of atopy in 220 children. Diagnostic reliability of skin prick tests and total and specific IgE levels

BACKGROUND: We have prospectively studied 220 children attending our Division because they suffered from atopic dermatitis (AD), asthma, and allergic rhinitis (AR), to assess the epidemiology of atopic diseases, and effectiveness of the diagnostic tests commonly used in allergic children. METHODS: Among the 220 children there were 142 males (64.5%) and 78 females (35.5%) aged as follows: 57 (25.9%) 0-2 year-old, 48 (21.8%) 2-4 year-old, 49 (22.3%) 4-6 year-old, 66 (30%) >6 year-old. The diagnosis included family and personal history, physical examination, skin prick tests (SPT) and total and specific IgE (sIgE) levels. We tested inhalant and food allergens. RESULTS: There were 101 asthmatic, 88 with AD, and 31 children with AR. The analysis of variance confirmed the age influence of PRIST with a high significance (p=0.0001). SPTs were prevalent in all groups for Der p, but casein only in 1 group, and Lolium perenne only in 2 groups. RAST showed a higher uniformity, that is CM (cow's milk) and egg for one group, Der p and Lolium perenne for the remaining groups Several correlations among diagnostic tests and the age of children were evaluated with the analysis of variance. CONCLUSIONS: We emphasize that atopic diseases are genetically transmitted, that AD develops at a younger age than asthma (p=0.0052), and that SPTs have a greater effectiveness for inhalant allergens, positive at all age levels; in food allergy (FA) SPTs are less adequate and feasible.     

上海嘉定地区儿童过敏原调查及过敏原与支气管哮喘的相关性

目的：分析上海嘉定地区过敏原及其与支气管哮喘发生的相关性。方法：上海嘉定南翔医院382 例4~12岁缓解期支气管哮喘患儿作为病例组（哮喘组）,采用整群随机法抽取上海嘉定地区2所学校和2所幼儿园402例4~10岁儿童（普查组）作为对照,对儿童家庭生活状况及过敏性疾病患病情况进行问卷调查,并进行18种常见过敏原皮肤点刺试验（SPT）。普查组按出生地分为移居组（219例）和常住组（183例）,分析家庭生活环境与SPT阳性率的相关性。结果：嘉定地区儿童过敏原主要为：粉尘螨、户尘螨、海虾、蟑螂、狗毛。哮喘组SPT阳性率为67.9%,显著高于普查组（31.8%）,二者差异有统计学意义（P＜0.01）。移居组家庭生活环境与常住组有明显差异（P＜0.01）,移居组SPT阳性率明显低于常住组,差异有统计学意义（P＜0.01）。结论：上海嘉定地区儿童主要过敏原为粉尘螨、户尘螨、海虾、蟑螂、狗毛;哮喘儿童对过敏原更具易感性;儿童生活环境与SPT阳性率存在一定相关性。     

Phadiatop和sIgE检测在儿童哮喘诊断中的应用

目的：探讨CAP过敏原检测系统中吸入性过敏原过筛试验(Phadiatop)检测和特异性IgE(sIgE)检测在小儿哮喘病因诊断中的价值。方法：应用荧光酶联免疫法,对153例小儿哮喘、40例支气管肺炎进行Phadiatop,sIgE和血清总IgE检测。结果：哮喘患儿Phadiatop和尘螨sIgE阳性率分别为 66.01%和59.48%,而支气管肺炎患儿两者阳性率分别为 12.5%和7.5%,两组间差异有显著性(P<0.05)。Phadiatop,sIgE灵敏度分别为0.66和0.59,特异度分别为0.88和0.93,两种检测的一致性高。结论：Phadiatop检测是哮喘病因诊断简便、可靠的体外过筛试验,Phadiatop阳性患儿应进一步作sIgE检测。     

温州地区儿童血清特异性过敏原检测的临床意义

目的了解温州地区不同年龄组儿童哮喘及过敏性疾病的过敏原状况,以指导临床防治。方法采用体外过敏原检测系统(法玛西亚CAP系统)对我院呼吸科门诊及住院患儿468例进行过敏原特异性IgE(sIgE)抗体检测,将所有受检儿童分为婴幼儿、学龄前、学龄期3组,对过敏原状况进行分析比较。结果哮喘发病主要集中于学龄前和婴幼儿期,过敏性鼻炎主要发生于学龄儿童;各种过敏性疾病中过敏性鼻炎sIgE阳性检出率最高,其次是哮喘和过敏性咳嗽;婴幼儿以食物过敏为主,较大年龄儿童以吸入性过敏为主,学龄前儿童两者均可发生;温州地区吸入性过敏原以尘螨为主,食入性以虾为主;在螨sIgE阳性者中哮喘比率最高,其次是过敏性鼻炎和过敏性咳嗽。结论螨及虾是温州地区儿童最常见过敏原。哮喘应在婴幼儿及学龄前期及早进行针对性防治,体外血清过敏原特异性抗体检测CAP系统是婴幼儿及学龄前儿童过敏原检测的方法之一。     

变态反应性疾病患儿猫、狗上皮的变应原反应性及抗原交叉性

目的探讨猫、狗上皮变应原与临床的相关性，以及与其他变成原的交叉反应性。方法采用国际标准化的变应原试剂13种，利用变应原皮肤点刺试验，对548例变态反应疾病患儿进行检测。结果判定以变应原试剂所致的皮肤红晕或风团的大小为标准，并以组胺液（1g／L）作为阳性对照，生理盐水作为阴性对照。结果猫上皮变应原皮试呈阳性143例。男98例，女45例；平均5.84岁。狗上皮变应原皮试呈阳性96例。男60例，女36例；平均6．06岁。夏秋季发病最多。许变态反应疾病最多为哮喘，其次是单纯咳嗽。猫和狗上皮变应原皮试均呈阳性64例。与其他变应原交叉反应性：螨虫〉乳〉动物蛋白〉霉菌〉花粉〉杂草。结论儿童变态反应人群中约20％患儿猫、狗上皮变应原皮试呈阳性反应；与年龄和季节有一定关系；此外，猫、狗上皮与其他变应原存在着广泛抗原交叉性。     

呼出气一氧化氮联合体外过敏原检测对识别反复喘息患儿中哮喘高危患儿的意义

目的探讨体外过敏原、呼出气一氧化氮(FeNO)联合检测对识别反复喘息患儿中哮喘高危患儿的临床价值。方法选取反复喘息患儿148例(0.5~6岁)为研究对象,80例门诊健康体检儿童为对照组。采用Pharmacia UniCAP免疫检测分析仪测定特异性免疫球蛋白(sIgE),纳库仑一氧化氮分析仪检测FeNO,并评估哮喘预测指数(API)。结果 148例反复喘息患儿中,sIgE阳性102例,阳性率为68.9%,明显高于对照组(11.3%,9/80)(P0.05)。喘息组患儿FeNO检测值及阳性率均明显高于对照组(P0.05)。喘息患儿的API总阳性率为32.4%,而API阳性患儿FeNO检测值为51±6 ppb,明显高于API阴性患儿(13±5 ppb)(P0.05)。sIgE阳性患儿中API阳性检出率为40.2%(41/102),FeNO阳性患儿中API阳性检出率为50.1%(38/73),二者阳性率比较差异无统计学意义。sIgE阳性+FeNO阳性组患儿中API阳性检出率为81.4%,明显高于sIgE、FeNO二者单独阳性组(P0.05)。结论 FeNO、体外过敏原联合检测对反复喘息患儿中哮喘高危患儿的检出率明显优于二者单独检测,二者联合检测为儿童哮喘的早期识别诊断、干预提供了良好的手段。     

变态反应性疾病患儿血清特异性IgE检测的临床意义

目的　探讨血清特异性IgE(sIgE)与儿童变态反应病发病的关系 ,为临床防治提供依据。 方法　采用法玛西亚公司的免疫CAP诊断系统 ,以荧光酶联免疫法测定sIgE。 结果　 71例患儿中可查到 5 4例 4 8种变应原阳性的sIgE ,有些患儿对多种变应原呈阳性反应。支气管哮喘患儿阳性检出率为 74 % (37∶5 0 ) ;变应性鼻炎患儿阳性检出率为 6 4 % (7∶11) ;特应性皮炎及湿疹患儿阳性检出率为 80 % (8∶10 )。主要阳性变应原为户尘螨、屋尘、蒿草、烟曲霉等吸入性变应原和鸡蛋白、牛奶、花生、黄豆等食物性变应原。年幼儿组 (3～ 6岁 )以食物性变应原为主 ;年长儿组 (7～ 15岁 )以吸入性变应原为主。对上述 8种变应原的sIgE两组之间定量比较 ,经秩和检验发现吸入性变应原蒿草的sIgE在组间有明显差异 ,年长儿组高于年幼儿组 (P <0 0 5 ) ;食物性变应原牛奶的sIgE在组间有明显差异 ,年幼儿组高于年长儿组 (P <0 0 5 )。结论　上述 8种变应原是引起太原地区儿童变态反应病的主要变应原 ,随年龄增长血清中吸入性变应原的sIgE的阳性率增多 ,食物性变应原的sIgE的阳性率减少 ;sIgE对外源性变态反应病阳性检出率高。     

变应性疾病患儿皮肤变应原试验与血清尘螨特异性IgE及IgG4水平的关系

目的探讨变应性疾病(包括支气管哮喘和变应性鼻炎)患儿常见的变应原与血清尘螨特异性IgE(sIgE)和IgG4水平的关系。方法对310例4～13岁变应性疾病儿童进行12种常见变应原皮肤点刺试验,同期采用夹心ELISA方法检测血清尘螨sIgE和IgG4水平。采用SPSS13.0软件进行统计学分析。结果变应性疾病儿童皮肤变应原检测阳性100%(310/310例),≥3种变应原阳性者占35.8%(111/310例)。引起变应性疾病的变应原主要为吸入物,阳性率最高的变应原是粉尘螨。变应性疾病儿童血清尘螨sIgE和IgG4水平明显高于健康对照组(t=14.253、12.314,Pa<0.01)。血清尘螨sIgE水平与皮肤变应原试验阳性种类的多少无相关性(r=-0.004 3,P>0.05);粉尘螨变应原阳性强度与血清尘螨sIgE水平呈正相关(r=0.219 8,P<0.05);血清尘螨sIgE水平与IgG4水平呈一定正相关(r=0.173 0,P<0.05)。结论变应原皮肤点刺试验有助于发现变应性疾病儿童的变应原及了解机体免疫状态强度,提供应尽可能避免接触的变应原,有条件者可进行脱敏治疗。监测血清sIgE和IgG4水平对...     

Epidemiology of atopy patch tests with food and inhalant allergens in an unselected population of children

Atopy patch test (APT) has been used as a diagnostic tool in patients with suspected food or inhalant allergy. This study assessed the prevalence of positive APT with food or inhalant allergens in an unselected population of schoolchildren. We also evaluated the link between positive APT reactions and skin‐prick tests (SPT) for food and inhalant allergens, circulating eosinophils and histamine skin reactivity. We studied an unselected population of 380 children aged 9 or 13 yr living in Rome, Italy. APTs were carried out with food (native or standardized) and inhalant allergens. All the children also underwent skin‐prick testing with five common inhalant and four food allergens. We also measured eosinophil cell counts and histamine skin reactivity. The prevalence of positive APT reactions for foods in unselected children ranged between 4% and 11% for hen’s egg, tomato, and wheat flour and was similar for both age groups studied. The prevalence of positive APT for milk was significantly lower in children aged 13 than in children aged 9 (p = 0.013). No concordance emerged between positive APT and SPT for foods. Conversely, APT and SPT for inhalant allergens yielded statistically significant concordance (p < 0.001). APT produces positive reactions for food or inhalant allergens in a significant number of subjects in the general population of schoolchildren. Age influences the prevalence of positive APTs with cow’s milk to some extent. Inhalant allergens probably induce a positive APT reaction through an immunoglobulin E‐linked process, while food allergens probably do not.     

儿童IgE相关食物过敏消化道临床特点及随访研究

目的　探讨儿童IgE相关食物过敏的消化道临床表现特点及其预后。方法　选取2012年3月至2013年11月首都医科大学附属北京儿童医院消化科174例IgE相关食物过敏患儿作为研究对象,结合过敏原IgE抗体检测结果,对致敏食物进行饮食回避,设计标准化调查问卷,对患儿的临床表现及预后进行定期随访。结果　174例过敏原特异性IgE抗体检测中,牛奶、鸡蛋为主要过敏原,分别占66.1%和27.6%,轻度敏感以牛奶为主（65.5%）,中度敏感以鸡蛋白为主（5.2%）。婴儿组消化道症状以腹泻为主（51.3%）,幼儿组以呕吐为主（37.5%）,学龄期及青春期组以腹痛为主要表现（43.5%）。牛奶过敏以腹泻为主要表现,占20.7%。以腹泻为主要临床表现患儿在过敏原特异性IgE浓度高低、过敏原数目方面,差异无统计学意义（P＞0.05）。牛奶特异性IgE 2级的患儿获得耐受的时间（7.54±5.11）个月长于牛奶特异性IgE 1级的患儿（3.50±3.53）个月,差异有统计学意义（P＜0.05）。结论　IgE相关的食物过敏患儿以牛奶和鸡蛋为主要的过敏原,患儿的消化道临床表现依据年龄组不同而有所差异,牛奶过敏患儿特异性IgE浓度越高越不易获得耐受。     

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??Objective??To observe the clinical characteristics and prognosis of children with IgE-related food allergy??Methods??The study was enrolled 174 children with food allergy in Beijing Children Hospital between March 2012 and November 2013. All patients were given treatment of avoid allergic food and filled out the standard questionnaire and followed up . Results??The sIgE positive rates of milk and eggs were higher than other food??were 66.1% and 27.6%. Mildly sensitive to milk was 65.5%??moderately sensitive to chicken protein was 5.2%. Main clinical manifestations of children with food allergy were vary in different age groups . In the infant group, diarrhea was the main manifestation??51.3%????and in the toddler group??vomiting was the main manifestation??37.5%??. In the school age and adolescence group??abdominal pain was the main manifestation??43.5%??. The severity of diarrhea are not connected with the types and concentration of allergens IgE. The results of follow-up analysis showed that patients of milk sIgE 2 level??7.54±5.1?? months need more longer time to acquire tolerance than sIgE 1 level??3.50±3.53?? months. Conclusion??Milk and eggs are the main allergens. The gastrointestinal symptoms of children with IgE-related food allergy were different with age. Children with high concentration of milk specific IgE is not easy to acquire food tolerance. The concentration of milk specific IgE had certain predictive value for the patient’s tolerance.     

Prediction of atopic disease in infancy by determination of immunological parameters: IgE, IgE- and IgG-antibodies to food allergens, skin prick tests and T-lymphocyte subsets

The possibility of predicting the development of atopic diseases up to 18 months of age, by using IgE, IgE- and IgG-antibodies (Ab) to food allergens, skin prick tests (SPT) and T-lymphocyte subsets, was prospectively studied in 163 infants with atopic heredity. IgE determinations in cord blood showed a positive allergy-predictive value of only 21%, using an optimal cut-off limit (≥ 0.9 kU/l). The corresponding figure for a weakly positive RAST (≥ 0.15 < 0.35 PRU/ml) to ovomucoid (OVO) or β-lactoglobulin (BLG) at 6 months of age was 25% and for a positive RAST ≥ 0.35 PRU/ml 100%. The predictive value of positive SPT to ovalbumin (OA), OVO, BLG and whole cow's milk varied between 67 and 100% and for IgG-Ab levels to the same food allergens the predictability did not exceed 30%. Total numbers of T cells (CD2, CD3) were higher (p < 0.05) at delivery among atopic infants, but neither in cord blood nor in blood samples, taken at 2 and 6 months of age, could absolute T-cell subset numbers or the CD4/CD8 ratios predict atopic diseases in more than 45% of the cases. A low sensitivity was observed in most of the parameters studied. Thus, none of the tests used in the present study seems suitable for predicting the development of atopic diseases during early infancy.     

变态反应性疾病患儿乳胶变应原反应性及抗原交叉性的研究

目的 探讨乳胶变应原皮试阳性与临床的相关性,以及乳胶变应原与其他变应原的交叉反应性。方法 采用国际标准化的变应原试剂13种,利用变应原皮肤点刺试验,对265例变态反应性疾病患儿进行检测。结果在79例乳胶变应原皮试呈阳性反应的患儿中,男性53例,女性26例;平均年龄为5．56岁;冬春季发病者28例,夏秋季发病者51例;哮喘者66例,过敏性皮肤病者5例,过敏性紫癜者1例,荨麻疹者1例,单纯咳嗽者6例。乳胶变应原反应率与性别和年龄无明显关系,而夏秋季反应率高于冬春季,有相应变态反应性临床症状者反应率高于无症状者。另外乳胶变应原与游虫变应原的交叉反应最为常见(100．O％),其次是动物蛋白变应原(62．O％～43．0％),与霉菌或植物花粉变应原交叉反应性最少(10．1％～3．8％)。结论 儿童变态反应人群中,有30％的患儿乳胶变应原皮试呈阳性反应,并且乳胶变应原反应性与性别和年龄无明显相关性,与相关变态反应临床痒状的有无和季节存在着明显相关件,另外乳胶变应原与多种变应原存存着交叉反府件。