Risk assessment of clinical reactions to legumes in peanut-allergic children 英文参考文献.docVIP

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Risk assessment of clinical reactions to legumes in peanut-allergic children 英文参考文献.doc

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Risk assessment of clinical reactions to legumes in peanut-allergic children 英文参考文献

ORIGINALARTICLE RiskAssessmentofClinicalReactionstoLegumes inPeanut-AllergicChildren LouiseBjerremannJensen,*||MileneAndersen,tPerStahlSkov,||§ LarsK.Poulsen,||andCarstenBindslev-Jensent their caretakers bene?t from a realistic knowledge of their Abstract: Peanut-allergicchildrenmightbeatriskfor reactions to personalthreshold. otherlegumes.However,itisnotalwayspossibletoperformmultiple Cross-reactivityisobservedwhenpreexistingimmuno- oralfoodchallengesinchildren.Onthebasisofpatientcasehistory, globulinE(IgE)antibodiesrecognizesimilarepitopesonother proteins than the protein they were originally sensitized to, invitrodiagnostictests,andeventuallyfoodchallenges,weaimedat developinganalgorithmfor riskassessmentofpossibleclinicalre- actionstootherlegumes(soybean,lupine,fresh,andblanchedgreen pea). Seventy-?ve consecutive patients with a positive oral food challengetopeanutwereincludedinthestudy.Alltestswererunas partoftheroutineallergyexamination.Ahighproportionofpatients and/or caretakers refused the administered legume oral food chal- lenges.Obtaineddiagnosesfromhistaminereleasedidnotcorrelate signi?cantlytotheoutcomeofthealgorithm.Interestingly,threshold frompeanutchallengesdidnotcorrelatewiththeriskassessment. Thealgorithmpresentedinthisstudycanbeusedwhenadvising peanut-allergic children and their caretakers about what other legumestoavoidinthediet. 4 and several studies on legume cross-reactivity have been 5 published. Magni et al investigated the degree of in vitro serologiccross-reactivitybetweenpeanutallergensandaller- gensfromsoybeanandlupineseedsbyWesternblottingand 2D gel electrophoresis. Theyfound that IgE antibodies spe- ci?c for Ara h 3 peanut allergens (an 11S globulin) also 5 recognizedsoybeanandlupine11Sglobulinbasicsubunits. 6 Wensing et al reported that patients sensitized to pea ex- hibitedclinicallyrelevantcross-reactivitytopeanutwherethe proteinresponsibleforthecross-reactionwasvicilin(Arah1 6 inpeanut). A serological cross-reactivity is, ho