Is Food-Triggered Atopic Dermatitis a Form of Systemic Contact Dermatitis?

IF 8.4 2区 医学 Q1 ALLERGY Clinical Reviews in Allergy & Immunology Pub Date : 2024-02-01 Epub Date: 2024-01-29 DOI:10.1007/s12016-023-08977-x
Kripa Ahuja, Christopher J Issa, Susan T Nedorost, Peter A Lio
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Abstract

Food allergy in atopic dermatitis is mediated by complex immune interactions between genetics, diet, environment, and the microbiome. When contact between inflamed skin and food antigens occurs, contact hypersensitivity can develop. Consequently, systemic contact dermatitis (SCD) can occur after ingestion of allergenic foods or food additives in the setting of a Th2 response with CLA-positive T cells, triggering dermatitis where skin resident memory lymphocytes reside. This phenomenon explains food-triggered dermatitis. Atopy patch tests (APTs) detect sensitization to food proteins responsible for SCD, which in turn can be confirmed by oral food challenge with delayed interpretation. We summarize the literature on using APTs to identify foods for oral challenge with dermatitis as an outcome. In dermatitis patients at risk for Th2 skewing based on a history of childhood-onset flexural dermatitis, shared decision-making should include a discussion of identifying and avoiding food and food additive triggers, as well as identifying and avoiding all contact allergens, prior to initiation of systemic therapy for dermatitis.

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食物引发的特应性皮炎是全身接触性皮炎的一种形式吗?
特应性皮炎的食物过敏是由遗传、饮食、环境和微生物组之间复杂的免疫相互作用介导的。当发炎的皮肤与食物抗原接触时,就会产生接触性过敏。因此,在摄入致敏食物或食品添加剂后,CLA 阳性 T 细胞会产生 Th2 反应,引发皮肤常驻记忆淋巴细胞所在部位的皮炎,从而导致全身接触性皮炎(SCD)。这一现象解释了食物诱发皮炎的原因。通过特应性斑贴试验(APT)可以检测出导致 SCD 的食物蛋白的致敏性,而这又可以通过口服食物挑战进行延迟解读来证实。我们总结了有关使用 APT 来确定以皮炎为结果的口服挑战食物的文献。对于因儿童期屈曲性皮炎病史而面临 Th2 偏移风险的皮炎患者,共同决策应包括在开始对皮炎进行系统治疗之前,讨论识别和避免食物及食物添加剂诱发因素,以及识别和避免所有接触性过敏原。
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来源期刊
CiteScore
22.30
自引率
1.10%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership. The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.
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