Abstract:
Allergenic cross-reactivity among food allergens complicates the diagnosis and management of food allergy. This can result in many patients being sensitized (having allergen-specific IgE) to foods without exhibiting clinical reactivity. Some food groups such as shellfish, fish, tree nuts, and peanuts have very high rates of cross-reactivity. In contrast, relatively low rates are noted for grains and milk, whereas many other food families have variable rates of cross-reactivity or are not well studied. Although classical cross-reactive carbohydrate determinants are clinically not relevant, α-Gal in red meat through tick bites can lead to severe reactions. Multiple sensitizations to tree nuts complicate the diagnosis and management of patients allergic to peanut and tree nut. This review discusses cross-reactive allergens and cross-reactive carbohydrate determinants in the major food groups, and where available, describes their B-cell and T-cell epitopes. The clinical relevance of these cross-reactive B-cell and T-cell epitopes is highlighted and their possible impact on allergen-specific immunotherapy for food allergy is discussed.
摘要:
食物过敏原之间的过敏交叉反应性使食物过敏的诊断和管理复杂化。这可导致许多患者对食物致敏(具有变应原特异性IgE)而不表现出临床反应性。一些食物组,如贝类,鱼,树坚果,和花生有非常高的交叉反应率。相比之下,谷物和牛奶的价格相对较低,而许多其他食物家族有可变的交叉反应率或没有得到很好的研究。尽管经典的交叉反应性碳水化合物决定因素在临床上并不相关,红肉中的α-Gal通过蜱叮咬会导致严重的反应。对树坚果的多种敏化使对花生和树坚果过敏的患者的诊断和管理复杂化。这篇综述讨论了主要食物组中的交叉反应性过敏原和交叉反应性碳水化合物决定因素,如果有的话,描述了它们的B细胞和T细胞表位。强调了这些交叉反应性B细胞和T细胞表位的临床相关性,并讨论了它们对食物过敏的过敏原特异性免疫疗法的可能影响。