台灣過敏病患中對常見食物與塵蟎之過敏盛行率調查   全文下載

The Prevalence of Specific IgE to Common Foods and Dust Mite in the Sera of Allergic Patients in Taiwan

因食入某種食品後所引起過度免疫之反應稱為食物過敏。於近十年來，食物過敏已變成為一個日益嚴重之問題。當此研究目的是由過敏病患中找出對食物過敏之血清來成立血清庫，作為食物過敏原之鑑定。此研究是由台中榮民總醫院過敏免疫門診共收集206過敏病患血清，檢測病患血清中之特異性E型抗體（specific IgE）來探討食物與塵?過敏盛行率，其中特別使用Phadia ImmunoCap特異過敏原抗體自動分析儀，過敏原品項包含玉米、稻米、大豆、花椰菜、花生及歐洲室塵?（Dermatophagoides pteronyssinus），另外並檢測致病機轉相關蛋白-10（pathogenesis related protein, PR-10）與脂質轉移蛋白（lipid transfer protein, LTP）之IgE陽性盛行率調查。結果顯示將近七成（70.4%）之過敏性病患有歐洲室塵?特異性IgE抗體，另外對食物IgE陽性率分別為玉米（10.7%）、稻米（7.3%）、大豆（7.8%）、花椰菜（10.2%）與花生（9.2%）。病患血清檢驗結果顯示其IgE抗體對致病機轉相關蛋白與脂質轉移蛋白都呈現低價數，並且IgE抗體反應顯示，脂質轉移蛋白跟榛果（hazelnut）與牆草屬植物（wall pellitory）具有交叉反應（cross-reactivity）。由過敏性疾病種類與特異性IgE抗體檢測結果顯示，有皮膚過敏之病患具有較高食物過敏之盛行率。雖然台灣過敏病患中，對塵?之IgE抗體價數遠高於食物，然而過敏病患血清中對塵?之IgE與食物之IgE具有很好的相關性。此研究發現皮膚性過敏比率中，男性好發率（53.2%）高於女性（35.8%），於食物（玉米、稻米、大豆、花椰菜、花生）之特異性IgE抗體於男性皆都高於女性。於過敏與年齡相關之調查結果顯示，小於18歲年齡之族群，皮膚性過敏症狀好發率明顯較高（63.9%）。呼吸性過敏症狀中，大於18歲之年齡好發率明顯較高（48.8%）。此研究顯示，不管是食物過敏原或是吸入性過敏原都可能使過敏體質之病患產生過多之IgE抗體，雖然其程度可能有所差異，但都有可能誘發並產生過敏性疾病。尤其是具有皮膚過敏病患之血清，特別容易對食物過敏產生IgE抗體，此病患之血清可用作未來檢測基改或是一般作物過敏原成分之鑑定。"

Food allergy refers to an abnormal immunologic response to foods. Food hypersensitivity reactions have become an increasingly troublesome issue over the last few decades. This study aims to investigate the prevalence of food allergies and to collect sera samples for the identification of allergens in foods. A total of 206 subjects from allergy and clinical immunology clinics, Taichung Veterans General Hospital were recruited in this study. The prevalence of food hypersensitivity was determined. The specific IgE to crude extracts of maize, rice, soybeans, broccoli, peanuts, Dermatophagoides pteronyssinus, allergen components of pathogenesis related protein-10 (PR-10) and lipid transfer protein (LTP), were measured using a Phadia ImmunoCAP autoanalyzer. A total of 70.4% subjects had specific IgE to D. pteronyssinus and close to 10% of all subjects had IgE to soybeans, rice, maize, broccoli, and peanuts. The IgE titer to LTP and PR-10 were low and had cross-reactivity with hazelnuts and wall pellitory. The relationship between allergic diseases and food specific IgE demonstrated that patients with skin allergy had a high prevalence of food hypersensitivity. There was a good correlation between the titer of IgE to D. pteronyssinus and food. Regarding the occurrence of skin allergies, there were higher incidences in the male subjects (53.2%) than in the female subjects (35.8%). The food-specific IgE (soybeans, rice, maize, broccoli, and peanuts) in male allergic subjects were apparently higher than female allergic subjects (p < 0.05). In the relationship between age and allergy, there were more younger-aged subjects (63.9%) with skin allergies than adult subjects (37.8%). However, there were more adult subjects (48.8%) with airway allergy than younger-aged subjects (27.8%). The percentage of mite specific IgE were apparently higher in the subjects under the age of 18 as compared with subjects over 18 years old. And the occurrence of airway allergy was mostly observed in subjects over 18 years old. However, the occurrence of skin allergy mostly happened in subjects under 18 years old. These results indicated that both food allergen and aeroallergen can be sensitized by the allergic subjects and may cause different degrees of severity of IgE responses. In conclusion, the sera containing allergen specific IgE to edible food can be collected from allergic subjects particularly those patients with skin allergies. These sera can be used for the detection of allergens in both conventional and genetically modified organisms.