基于家庭的小麦口服免疫疗法:实际效果和预测因素分析。

IF 2.3 4区 医学 Q3 ALLERGY
Jiwon Kim, Minyoung Jung, Sehun Jang, Sanghee Shin, Jeongmin Song, Sukyung Kim, Ji Young Lee, Hyun Mi Kim, Yeonghee Kim, Min Hee Lee, Su Jin Lee, Minji Kim, Jihyun Kim, Kangmo Ahn
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引用次数: 0

摘要

背景:小麦过敏是韩国最常见的过敏原之一,会降低生活质量并对营养造成影响:我们的目的是调查使用小麦面条对小麦过敏儿童进行家庭小麦口服免疫疗法(OIT)的有效性和安全性:我们进行了一项回顾性研究,涉及 72 名被诊断为小麦过敏的 3 至 17 岁儿童。患者接受了使用小麦面条的小麦 OIT(50 人),并与历史对照组(22 人)进行了比较。对基线特征、不良事件和免疫学变化进行了评估。通过逻辑回归分析确定了成功脱敏的预测因素:结果:在完成增量给药阶段的 50 名患者中,82.0% 的患者对 2400 毫克小麦蛋白实现了脱敏,而对照组仅为 4.5%(p < 0.001)。在增加剂量期间,每人的不良反应中位数为 2 次,30.0% 的患者(15/50)出现过敏性休克。不过,没有出现危及生命的不良反应。在多变量分析中,是否患有哮喘(调整赔率[aOR],8.88;95% 置信区间[CI],1.10-71.97;p = 0.041)以及特异性 IgE(sIgE)与ω-5-花生蛋白和总 IgE 的比率是否较高(aOR 19.09,95%CI 1.21-300.80,p = 0.036)与小麦 OIT 的治疗结果显著相关:我们的研究表明,在韩国小麦过敏儿童中使用煮熟的面条进行家庭小麦 OIT 既安全又有效。对于ω-5-gliadin sIgE 与总 IgE 比值基线升高且有哮喘病史的患者,应慎重考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Home-based up-dosing of wheat oral immunotherapy: Real-world effectiveness and predictive factor analysis.

Background: Wheat allergy is one of the most prevalent allergens in Korea, decreasing quality of life and causing nutritional repercussions.

Objective: We aimed to investigate the efficacy and safety of the home-based wheat oral immunotherapy (OIT) using wheat noodles in children with a wheat allergy.

Methods: We conducted a retrospective study involving 72 children aged 3 to 17 years diagnosed with a wheat allergy. Patients received wheat OIT using wheat noodles (n = 50) and were compared with a historical control group (n = 22). Baseline characteristics, adverse events, and immunological changes were assessed. Predictors of successful desensitization were identified using logistic regression analysis.

Results: Among 50 patients completing the up-dosing phase, 82.0% achieved desensitization to 2,400 mg of wheat protein, compared to 4.5% in the control group (p < 0.001). During the up-dosing period, the median number of adverse reactions per person was 2, and anaphylaxis occurred in 30.0% (15/50). However, there were no life-threatening adverse events. In multivariable analysis, the presence of asthma (adjusted odds ratio [aOR], 8.88; 95% confidence interval [CI], 1.10-71.97; p = 0.041) and a higher ratio of specific IgE (sIgE) to ω-5-gliadin and total IgE (aOR 19.09, 95%CI 1.21-300.80, p = 0.036) were significantly associated with treatment outcomes of wheat OIT.

Conclusion: Our study showed the safety and efficacy of home-based wheat OIT using boiled noodles in Korean children with wheat allergies. Careful consideration is warranted for patients with elevated baseline sIgE to ω-5-gliadin to total IgE ratio and a history of asthma.

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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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