——浙大迪迅 譯

背景：在歐盟，食品必須標(biāo)明14種主要過敏原。合理的過敏原標(biāo)簽需要了解來自基于人群食物挑戰(zhàn)的閾值。本研究的目的是評估臨床驗證的食物過敏患者中強制性標(biāo)簽過敏原的閾值分布。

方法：包括在丹麥歐登塞大學(xué)醫(yī)院過敏中心進行開放性口服食物挑戰(zhàn)和雙盲安慰劑對照食物挑戰(zhàn)（DBPCFC）（2000-2022）的所有陽性數(shù)據(jù)。對于每個納入的挑戰(zhàn)，獲得累積閾值（LOAEL）并估計NOAEL。數(shù)據(jù)被建模為區(qū)間截尾對數(shù)正態(tài)分布。

結(jié)果：總體而言，1229例患者(717例男性，986例兒童)的2612例挑戰(zhàn)中有38例(1.5%)對<5 mg蛋白質(zhì)有反應(yīng)。大多數(shù)最敏感的患者反應(yīng)的Sampson嚴(yán)重程度評分為2-3。使用間隔剔除對數(shù)正態(tài)模型，只有5組(雞蛋、魚、花生、牛奶、堅果)在攝入0.5 mg蛋白質(zhì)后引起反應(yīng)，并且在人群中頻率較低。雞蛋是最強效的過敏原，0.24%[0.13-0.44%]的雞蛋過敏患者對<0.5 mg蛋白質(zhì)的反應(yīng)性，而對大多數(shù)其他過敏原產(chǎn)生0.5 mg蛋白質(zhì)誘導(dǎo)劑量的過敏患者的估計比例低于0.04%。

結(jié)論：研究表明，大多數(shù)食物過敏患者都能像預(yù)期的那樣耐受微量過敏性食物，而不會出現(xiàn)嚴(yán)重的過敏癥狀和體征。雞蛋似乎是最容易在極低劑量下引起最敏感個體反應(yīng)的食物。

原始出處
Allergy
Challenge-verified thresholds for allergens mandatory for labeling: How little is too much for the most sensitive patient?
DOI: 10.1111/all.15870
Abstract:
Background:It is mandatory to label food products with the 14 main allergens in the EU. Reasonable allergen labeling requires knowledge of population-based thresholds derived from food challenges. The aim of this study was to evaluate the threshold-distribution in clinically verified food allergic patients for allergens mandatory for labeling.
Methods:All positive open oral food challenges and double-blind placebo-controlled food challenges (DBPCFC) performed at the Allergy Center, Odense University Hospital, Denmark (2000–2022) were included. For each included challenge, the cumulative threshold (LOAEL) was obtained and NOAEL estimated. Data were modelled as an interval censored log-normal distribution.
Results:Overall, 38 of all 2612 challenges (1.5%) in 1229 patients (717 male, 986 children) reacted to <5 mg protein. The majority of the most sensitive patients reacted with a Sampson severity score of 2–3. Using interval censored log-normal models only five groups (hens′ egg, fish, peanut, milk, tree-nuts) elicited reactions after ingestion of 0.5 mg protein and in low frequencies of the population. Hen's egg was the most potent allergen, with reactivity to <0.5 mg protein in 0.24% [0.13–0.44%] of egg allergic patients while the estimated fraction of allergic patients reacting to a eliciting dose on 0.5 mg protein for most other allergens were below 0.04%.
Conclusion:Our data demonstrates that the majority of food allergic patients as expected tolerating traces of allergenic foods without developing severe allergic symptoms and signs. Hen's egg appears to be the food most likely to elicit reactions in the most sensitive individuals at very low doses.
First Author:
Charlotte G
Corresponding author:
Charlotte G
Correspondence: Mortz, Department of Dermatology and Allergy Centre, ORCA (Odense Research Center for Anaphylaxis), Odense University Hospital, Kl?verv?nget 15, DK-5000 Odense C, Denmark.
Email: charlotte.moertz@rsyd.dk