nonimmunoglobulin e-mediated immune reactions to foodsnonimmunoglobulin e-mediated免疫反应的食物.pdfVIP

Review Article Nonimmunoglobulin E–Mediated Immune Reactions to Foods Jonathan M. Spergel, MD, PhD Abstract Adverse food reactions are abnormal responses to ingested foods. Reactions vary from immunologic to nonimmunologic immune reactions and can be either immunoglobulin E (IgE) mediated or non-IgE mediated. Food-induced IgE-mediated reactions range from localized urticaria to anaphylaxis and have been well studied. However, in comparison, there has been significantly less research into non–IgE- mediated food reactions. Non–IgE-mediated reactions can cause respiratory, gastrointestinal, and cutaneous symptoms. The most recent evidence suggests that these reactions are probably T-cell mediated as evidenced in lymphocyte proliferation assays. This review will explore the symptoms and testing methods of the most common non–IgE-mediated reactions. An adverse food reaction is any abnormal response last several years and include food protein–induced to an ingested food, regardless of the pathophys- enterocolitis syndrome and allergic eosinophilic iology. One classification scheme separates esophagitis. Non–IgE-mediated food reactions immunologic from nonimmunologic entities. Non- are classified as negative skin test results or spe- immune reactions include jitteriness from caf- cific IgE to foods, with positive challenge to the feine and metabolic disorders such as lactase defi- offending food. The reactions can vary by system, ciency. Immune reactions are divided into those from gastrointestinal (GI) to cutaneous to respi- that are immunoglobulin E (IgE)-mediated and ratory; gastrointestinal reactions are the most com- those that are not IgE mediated. IgE-mediated mon reactions (Table 1). reactions are the classic presentations of food In regard to biology and documentation, food- allergy, such as hive