小麦口服免疫疗法的治疗困难与小麦特异性 IgE 的预测价值。

IF 2.3 4区 医学 Q3 ALLERGY
Punchama Pacharn, Siriluck Witeetanavanich, Witchaya Srisuwatchari, Nuntanut Rutrakool, Chulamanee Wongteerayanee, Pattara Tanticharoenwiwat, Anchalee Senavonge, Kantima Kanchanapoomi, Orathai Jirapongsananuruk, Nualanong Visitsunthorn, Pakit Vichyanond
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引用次数: 0

摘要

背景:与IgE介导的小麦过敏患者的小麦口服免疫疗法(OIT)困难相关的因素尚未得到充分研究:我们旨在评估与小麦口服免疫疗法困难相关的因素:我们回顾性地收集了 18 岁以下有 IgE 介导的小麦过敏史并接受了小麦 OIT 的儿童的数据。评估了小麦和ω-5-花生蛋白的初始特异性 IgE(sIgE)、小麦皮肤点刺试验(SPT)的大小、诱发剂量以及 OIT 期间的不良反应:共有 81 名儿童接受了小麦 OIT 治疗,开始治疗时的平均年龄为 7.0±2.7 岁。随访时间中位数为 2 年(IQR 1.2 -3.0 年)。在小麦 OIT 中遇到困难的患者包括经常出现反应(至少 2 级或运动诱发反应)或偏离加量方案的患者,我们将其定义为 "复杂病例"。26 名患者(32.1%)属于复杂病例。复杂病例的初始小麦 IgEs 明显高于非复杂病例(中位数为 192.3 kUA/L(IQR 30.4-590.0)vs 6.9 kUA/L(IQR 1.9-100.0)(p = 0.001))。并发症组的初始ω-5-gliadin-sIgEs 也明显较高,中位数为 15.0 kUA/L (IQR 6.3-69.8) vs 1.6 kUA/L (IQR 0.2-11.4) (p < 0.001)。复杂病例的风险因素包括较高的ω-5-gliadin-sIgEs和口服食物挑战试验中的过敏性休克(aOR分别为1.035和5.684):最初的小麦和ω-5-gliadin-sIgEs是导致复杂OIT患者的重要风险因素,可用于在OIT期间对这些患者进行仔细监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment Difficulties in Wheat Oral Immunotherapy and the Predictive Value of Wheat-Specific IgE.

Background: Factors associated with wheat oral immunotherapy (OIT) difficulties in patients with IgE-mediated wheat allergy have not been well studied.

Objective: We aimed to assess factors associated with difficulties in wheat OIT.

Methods: We retrospectively collected data from children under 18 years of age with history of IgE-mediated wheat allergy who underwent wheat OIT. The initial specific IgE (sIgE) of wheat and omega-5-gliadin, wheat skin prick test (SPT) sizes, eliciting doses, and adverse reactions during the OIT were evaluated.

Results: A total of 81 children were enrolled, with a mean age of 7.0 ± 2.7 years at the initiation of wheat OIT. The median follow-up duration was 2 years (IQR 1.2 -3.0 years). Difficulties in wheat OIT included patients who experienced frequent reactions (at least grade 2 or exercise-induced reactions) or deviated from the up-dosing protocol, which we defined as 'Complicated cases.' Twenty-six patients (32.1%) were complicated cases. Initial wheat-sIgEs were significantly higher in complicated cases than in noncomplicated cases (median of 192.3 kUA/L (IQR 30.4-590.0) vs 6.9 kUA/L (IQR 1.9-100.0) (p = 0.001)). Initial omega-5-gliadin-sIgEs in the complicated group were also significantly higher, with a median of 15.0 kUA/L (IQR 6.3-69.8) vs 1.6 kUA/L (IQR 0.2-11.4) (p < 0.001). The risk factors for complicated cases include higher omega-5-gliadin-sIgEs and anaphylaxis during the oral food challenge test (aOR 1.035 and 5.684, respectively).

Conclusion: The initial wheat and omega-5-gliadin-sIgEs were significant risk factors for complicated OIT patients and could be used to monitor these patients carefully during the OIT period.

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来源期刊
CiteScore
12.80
自引率
0.00%
发文量
74
审稿时长
>12 weeks
期刊介绍: The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747 APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume. APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand. The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.
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