超低剂量口服食物挑战对严重母鸡蛋过敏儿童的疗效:回顾性单中心病例系列。

IF 6.2 2区 医学 Q1 ALLERGY Allergology International Pub Date : 2024-06-20 DOI:10.1016/j.alit.2024.05.006
Kosei Yamashita, Maeda Mayu, Takanori Imai, Toshiyuki Takagi, Megumi Okawa, Aiko Honda, Chihiro Kunigami, Yuki Okada, Taro Kamiya
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引用次数: 0

摘要

背景:为避免从饮食中完全排除鸡蛋(HE),我们于2019年在严重HE过敏患者中引入了超低剂量(VLD)口服食物挑战(OFC)。在此,我们研究了VLD HE OFC对实现全剂量OFC的疗效:纳入6个月内对LD(1/32 HE [≤100 mg])或更少、蛋白(EW)蛋白有明显过敏反应的患者。在 VLD 组中,排除了 2 年内未达到全剂量 OFC(1/2 HE:1600 毫克 EW 蛋白)的患者。我们回顾性比较了 2019 年前接受 LD OFC 的患者(LD 组)和 2019 年后接受 VLD OFC(1/100 HE:32 毫克 EW 蛋白)的患者(VLD 组)通过全剂量 OFC 的比率。采用 Kaplan-Meier 生存分析法评估了通过全剂量 OFC 的时间:我们在 LD 组和 VLD 组分别招募了 411 名和 111 名患者。LD 组和 VLD 组患者开始使用 OFC 时的中位年龄分别为 2.2 [1.5-3.6] 岁和 2.1 [1.4-3.2] 岁。LD组的EW和卵模特异性IgE水平分别为38.3(12.5-72.9)和21.0(8.3-46.2)kUA/L,VLD组分别为49.8[18.8-83.9]和32.1[15.6-67.8]kUA/L。4 年中,LD 组和 VLD 组的全剂量 OFC 通过率分别为 70% 和 95%,差异显著(对数秩检验,P 结论):VLD HE OFC 可能有助于严重 HE 过敏患者通过全剂量 OFC。
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Efficacy of very-low-dose oral food challenge in children with severe hen egg allergy: A retrospective, single-center case series.

Background: To avoid complete elimination of hen eggs (HE) from diet, we introduced a very-low-dose (VLD) oral food challenge (OFC) in patients with severe HE allergy in 2019. Herein, we investigated the efficacy of VLD HE OFC for achieving the full dose OFC.

Methods: Patients with an overt allergic reaction to LD (1/32 HE [≤100 mg]) or less, egg white (EW) protein within 6 months were included. In the VLD group, patients not achieving full-dose OFC (1/2 HE: 1600 mg EW protein) within 2 years were excluded. We retrospectively compared the rate of passing a full-dose OFC between patients who underwent a LD OFC before 2019 (LD group) and those who underwent a VLD OFC (1/100 HE: 32 mg EW protein) after 2019 (VLD group). The period for passing the full-dose OFC was evaluated using Kaplan-Meier survival analysis.

Results: We enrolled 411 and 111 patients in the LD and VLD groups, respectively. The median age at OFC initiation was 2.2 [1.5-3.6] and 2.1 [1.4-3.2] years in the LD and VLD groups, respectively. EW- and ovomucoid-specific IgE levels were 38.3 (12.5-72.9) and 21.0 (8.3-46.2) kUA/L in the LD group and 49.8 [18.8-83.9] and 32.1 [15.6-67.8] kUA/L in the VLD group, respectively. Over 4 years, the LD and VLD groups passed the full-dose OFC at rates of 70 and 95%, respectively, with significant differences (log-rank test, P < 0.001).

Conclusions: VLD HE OFC may contribute to passing a full-dose OFC in patients with severe HE allergies.

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来源期刊
Allergology International
Allergology International ALLERGY-IMMUNOLOGY
CiteScore
12.60
自引率
5.90%
发文量
96
审稿时长
29 weeks
期刊介绍: Allergology International is the official journal of the Japanese Society of Allergology and publishes original papers dealing with the etiology, diagnosis and treatment of allergic and related diseases. Papers may include the study of methods of controlling allergic reactions, human and animal models of hypersensitivity and other aspects of basic and applied clinical allergy in its broadest sense. The Journal aims to encourage the international exchange of results and encourages authors from all countries to submit papers in the following three categories: Original Articles, Review Articles, and Letters to the Editor.
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