[Non-IgE-mediated food allergy].

María Isabel Rojo Gutiérrez, Diego Ballesteros González, Ana Karen Ortiz Durán
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Abstract

Food allergy is an immune response to proteins in food. It usually affects 8% of children and 2% of adults in Western countries. Non-IgE-mediated food allergy mainly affects the gastrointestinal tract. Gastrointestinal food allergies are classified, by their underlying pathogenesis, as: IgE-mediated, non-IgE-mediated, or mixed. The symptoms of patients with food protein-induced allergic proctocolitis originate from local inflammation of the distal colon, which causes hematochezia in neonates. It can affect the entire gastrointestinal tract and cause symptoms of intractable emesis, with subsequent metabolic disorders and hypovolemic shock. Food protein-induced enterocolitis syndrome is a non-IgE-mediated allergy that usually appears in childhood, with prolonged repetitive vomiting, starting 1 to 4 hours after ingestion of food. The manifestation in adults is usually triggered by the consumption of shellfish. Atopic diseases affect 40-60% of patients with food protein- induced enterocolitis syndrome, including 40-50% of those with food protein-induced enteropathy and proctocolitis. Probiotics (Lactobacillus GG) can alleviate the symptoms of allergic proctocolitis induced by food proteins, by altering the composition of the intestinal microbiota. Fecal microbiota transplantation (FMT) can change intestinal microecology efficiently compared to food or probiotics.

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[非 IgE 介导的食物过敏]。
食物过敏是对食物中蛋白质的一种免疫反应。在西方国家,通常有8%的儿童和2%的成年人会受到影响。非 IgE 介导的食物过敏主要影响胃肠道。胃肠道食物过敏按其基本发病机制可分为:IgE介导、非IgE介导或混合型。食物蛋白诱导的过敏性直肠结肠炎患者的症状源于远端结肠的局部炎症,在新生儿中会引起血便。它可影响整个胃肠道,引起难治性呕吐症状,继而导致代谢紊乱和低血容量休克。食物蛋白诱发的小肠结肠炎综合征是一种非 IgE 介导的过敏症,通常出现在儿童时期,在摄入食物 1 至 4 小时后开始出现长时间反复呕吐。成人的表现通常由食用贝类引发。异位性疾病影响到 40-60% 的食物蛋白诱发肠炎综合征患者,其中包括 40-50% 的食物蛋白诱发肠病和直肠结肠炎患者。益生菌(乳酸杆菌 GG)可以通过改变肠道微生物群的组成,减轻食物蛋白诱发的过敏性直肠结肠炎的症状。与食物或益生菌相比,粪便微生物群移植(FMT)能有效改变肠道微生态。
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