Skin prick testing does not reflect the presence of IgE against food allergens in adult eosinophilic esophagitis patients a case study 英文参考文献.docVIP

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Skin prick testing does not reflect the presence of IgE against food allergens in adult eosinophilic esophagitis patients a case study 英文参考文献.doc

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Skin prick testing does not reflect the presence of IgE against food allergens in adult eosinophilic esophagitis patients a case study 英文参考文献

Kamdaretal.ClinicalandMolecularAllergy2010,8:16 /content/8/1/16 CMA CASE REPORT OpenAccess Skinpricktestingdoesnotreflectthepresence ofIgEagainstfoodallergensinadulteosinophilic esophagitispatients:acasestudy ToralAKamdar,AnneMDitto,PaulJBryce* Abstract Skinpricktestingiswidelyusedtopredictthepresenceofallergen-specificIgE.Ineosinophilicesophagitis patients,whofrequentlyexhibitpolysensitizationandbroadreactivityuponskinpricktesting,thisiscommonly usedtoaidavoidancerecommendationsintheclinicalmanagementoftheirdisease.Wepresentherethepredic- tivevalueofskinpricktestingforthepresenceofallergen-specificIgE,in12patients,determinedbyimmunoblot againsttheallergenextractsusingindividual-matchedserum.Ourresultsdemonstrateahighdegreeofpredictive valueforaeroallergensbutapoorpredictivevalueforfoodallergens.Thissuggeststhatskinpricktestinglikely identifiesIgEreactivitytowardsaeroallergensinadulteosinophilicesophagitisbutthisisnottrueforfoods. Consequently,IgEimmunoblottingmightberequiredfordeterminingfoodavoidanceinthesepatients. Background and one food allergen. None of the patients has a his- Eosinophilicesophagitis(EoE)isagastrointestinaldisor- toryofIgE-mediatedfoodallergyand,insteadhadbeen derthatisassociatedwithallergicdisease.Studieshave determined asEoEpatients duetoahistory ofdyspha- describedpersonalorfamilyhistoriesofasthmaoraller- gia, presence of endoscopic characteristics (e.g. rings, gic rhinitis in adult EoE patients [1,2] and a murine furrows,strictures)andpathologicalassessmentofeosi- modelhasshownthataeroallergensensitizationmaybe nophils in esophageal biopsy tissue that were greater responsiblefortheeosinophilicresponseintheesopha- than 25 per high powered field (hpf). Western blot- gus [3]. Adult EoE patients display a broad range of basedscreening forIgE-specific recognition ofproteins reactivitytomultipleallergensthatspansbothaeroand in 5 aero and 5 food allergen extracts was undertaken food allergens. In one study, 81