原標(biāo)題：牛奶組分特異性IgE在評估牛奶過敏耐受中的作用
　　本研究的目的是評估牛奶中特定IgE水平在預(yù)測牛奶過敏患者臨床耐受性方面的作用。
　　采用IMMULITE 2000 (3gAllergy)方法，對43例(43例)牛奶過敏、口服免疫治療的患者的牛奶及其成分酪蛋白、α-乳蛋白(ALA)、β-乳球蛋白(BLG)和乳清特異性IgE水平進(jìn)行檢測。同樣，牛奶、酪蛋白、ALA和BLG特異性IgE水平通過ImmunoCAP檢測，描述為CAPmilk、cap酪蛋白、CAPALA和CAPBLG。計(jì)算了上述9個(gè)參數(shù)與總IgE水平的比值。所有數(shù)據(jù)均采用ROC曲線分析，并根據(jù)患者對熱牛奶的耐受性設(shè)定狀態(tài)變量。我們將不能耐受10ml加熱牛奶的患者定義為高危患者，不能耐受100ml以上加熱牛奶的患者定義為低?；颊?。
　　各組的年齡、血清總IgE水平無顯著差異。通過對這些數(shù)據(jù)的分析，預(yù)測高危患者的最佳5個(gè)參數(shù)分別為ALA/IgE、乳清/IgE、milk/IgE、CAPmilk/IgE、酪蛋白/IgE，其auc分別為0.904、0.892、0.887、0.860和0.855。預(yù)測低?；颊叩淖罴?個(gè)參數(shù)為ALA/IgE、BLG、乳清/IgE、milk/IgE、酪蛋白，其auc分別為0.914、0.899、0.897、0.892、0.887。CAP ALA無法預(yù)測任耐受。
　　延伸閱讀
JACI   
Utility of Measuring Cow's Milk Components Specific IgE Levels in Evaluating Clinical Tolerance of Milk Allergy
DOI: 10.1016/j.jaci 2015.12.590
Abstract:
Rationale
The purpose of this study was to evaluate the utility of cow’s milk components specific IgE levels in predicting clinical tolerance in patients with milk allergy.
Methods
Forty-three (43) patients with milk allergy, undertaking oral immunotherapy were examined for cow’s milk and it’s components, casein, alpha-lactalbumin (ALA), beta-lactoglobulin (BLG), and whey specific IgE levels using IMMULITE 2000 3gAllergy (3gAllergy). Also milk, casein, ALA, and BLG specific IgE levels were measured by ImmunoCAP, describing as CAPmilk, CAPcasein, CAPALA, and CAPBLG. The ratios of 9 parameters mentioned above and total IgE levels were calculated. All data were analyzed by ROC curve analysis with setting the state variables according to how much heated milk each patient could tolerate. We defined a patient who could not tolerate 10ml of heated milk as a high risk patient and one who could tolerate over 100ml of heated milk as a low risk patient.
Results
Month of ages and serum total IgE levels were not significantly different between the groups. As analyzing these data, the best five parameters to predict high risk patients were ALA/IgE, whey/IgE, milk/IgE, CAPmilk/IgE, and casein/IgE, and their AUCs were 0.904, 0.892, 0.887, 0.860, and 0.855, respectively. Also, the best five parameters to predict low risk patients were ALA/IgE, BLG, whey/IgE, milk/IgE, and casein, and their AUCs were 0.914, 0.899, 0.897, 0.892, and 0.887, respectively. CAPALA could not predict any tolerances.
Conclusions
The ALA level using 3gAllergy was the best predictor for both high risk and low risk patients, especially when considering ithe nfluence of total IgE levels.
All Authors
Kazuyo Koizumi  Munemistsu Koizumj  Koji Nishimura  Michiko Okamoto  Eijchi Lshij
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺(tái)，為過敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺(tái)。