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　　原标题：与牛奶过敏反应或乳糖-α-1、3-乳糖过敏病人相比，嗜酸细胞性食管炎患者中的过敏原组份特异性IgG4优先升高
　　①食物过敏的发生率正在增加，包括具有明显独特病理生理的疾病，如嗜酸细胞性食管炎(EoE)、牛奶过敏和半乳糖-1,3-半乳糖(alpha-gal)过敏。虽然包括IgG4在内的其它抗体亚型的作用尚不清楚，但IgE在这些疾病中的作用已经得到了很好的研究②在这里，我们评估了来自弗吉尼亚大学的随机选择的患有EoE、牛奶过敏反应和α-半乳糖肉类过敏患者血清中的相关组份过敏原特异性IgG4的水平。IgG4和IgE水平采用商业化的免疫cap技术或生物素化抗原偶联链霉亲和素免疫吸附测定法。③与牛奶过敏反应或非过敏对照组相比，EoE患者中牛奶组份过敏原Bos d4 (α-乳白蛋白)和Bos d5 (β-乳球蛋白)特异性IgG4平均水平比牛奶过敏反应组或非牛奶过敏对照组高10倍。这也与EoE与牛奶过敏反应之间IgE/IgG4比值的显著变化有关。与牛奶过敏反应的趋势相似，但与EoE相反，α-半乳糖过敏患者的相关过敏原组份半乳糖-α-1、3-半乳糖特异性IgE水平相对于特异性IgG4是显著升高的。④与其他食物过敏(包括牛奶过敏和α-半乳糖过敏，主要是IgE反应)相比，EoE中相关过敏原特异性IgG4的水平独特地升高。这项使用特定组份检测的初步工作是建立在先前的研究基础之上的，这些研究表明IgG4在EoE中优先升高。研究还显示，尽管临床反应延迟，α-半乳糖过敏在IgE、IgG4方面的特征类似于其它速发型超敏反应。
延伸阅读
JACI:IgG4 Component Allergens Are Preferentially Increased in Eosinophilic Esophagitis As Compared to Patients with Milk Anaphylaxis or Galactose-Alpha-1,3-Galactose Aller
DOI: https://doi.org/10.1016/j.jaci.2015.12.780
Abstract：
Rationale
Incidence of food allergy is increasing, including diseases with apparently unique pathophysiologic pathways such as eosinophilic esophagitis (EoE), milk anaphylaxis and galactose-alpha-1,3-galactose (alpha-gal) allergy. The role of IgE in these diseases has been well studied, though the contribution of other antibody subtypes, including IgG4, is less clear.
Methods
Here we assessed IgG4 levels to relevant component allergens from sera banked at the University of Virginia in randomly selected patients carrying diagnoses of EoE, milk anaphylaxis and alpha-gal meat allergy. IgG4 and IgE levels were measured with ImmunoCap technology using commercial assays or biotinylated antigen coupled to streptavidin immunosorbent.
Results
IgG4 geometric mean levels to milk component allergens Bos d 4 (α-lactalbumin) and Bos d 5 (β-lactoglobulin) were >10 fold higher in EoE patients than milk anaphylaxis or non-allergic controls. This also correlated with a pronounced shift in the IgE/IgG4 ratio between EoE and milk anaphylaxis. Similar to the trend seen in milk anaphylaxis but contrary to EoE, alpha-gal patients had marked relative increase in IgE versus IgG4 levels to the relevant allergen galactose-alpha-1,3-galactose.
Conclusions
Levels of IgG4 to relevant allergen are uniquely elevated in EoE as compared to other food allergies, including milk anaphylaxis and alpha-gal, where IgE is the dominant response. This preliminary work using component-specific testing builds on prior studies demonstrating that IgG4 is preferentially elevated in EoE. It also highlights that despite a delayed clinical response alpha-gal shares an IgE-to-IgG4 signature similar to other immediate hypersensitivity reactions.
All Authors
Jeffrey M. Wilson  Alexander J. Schuyler Anubha Tripathi Elizabeth A. Erwin
Scott P. Commins Thomas A.E. Platts-Mills
　　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。