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　　原标题：牛奶组分特异性IgE在评估牛奶过敏耐受中的作用
　　本研究的目的是评估牛奶中特定IgE水平在预测牛奶过敏患者临床耐受性方面的作用。
　　采用IMMULITE 2000 (3gAllergy)方法，对43例(43例)牛奶过敏、口服免疫治疗的患者的牛奶及其成分酪蛋白、α-乳蛋白(ALA)、β-乳球蛋白(BLG)和乳清特异性IgE水平进行检测。同样，牛奶、酪蛋白、ALA和BLG特异性IgE水平通过ImmunoCAP检测，描述为CAPmilk、cap酪蛋白、CAPALA和CAPBLG。计算了上述9个参数与总IgE水平的比值。所有数据均采用ROC曲线分析，并根据患者对热牛奶的耐受性设定状态变量。我们将不能耐受10ml加热牛奶的患者定义为高危患者，不能耐受100ml以上加热牛奶的患者定义为低危患者。
　　各组的年龄、血清总IgE水平无显著差异。通过对这些数据的分析，预测高危患者的最佳5个参数分别为ALA/IgE、乳清/IgE、milk/IgE、CAPmilk/IgE、酪蛋白/IgE，其auc分别为0.904、0.892、0.887、0.860和0.855。预测低危患者的最佳5个参数为ALA/IgE、BLG、乳清/IgE、milk/IgE、酪蛋白，其auc分别为0.914、0.899、0.897、0.892、0.887。CAP ALA无法预测任耐受。
　　延伸阅读
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
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。