①大豆过敏是最常见的食物过敏之一。大豆组分贮藏蛋白Gly m4、m5、m6特异性IgE检测，被认为是提高大豆过敏反应（系统性和局部）特异性鉴定能力的一种方法②本研究回顾性分析了国家实验室对样本进行Gly m4、5、6特异性 IgE (Phadia ImmunoCAP)检测的结果。根据目前的研究，利用国际标准0.35kU/L作为IgE检测阳性的临界值，将未鉴定的患者样本的数据编入危险组。③在样本组中，46%的患者对至少一种大豆组份有反应。在这些患者中，39%的患者仅对Gly m5和Gly 6有反应，这两种成分最能说明大豆对患者有严重的全身反应。对Gly m4有反应的患者仅占37%，对所有成分均有反应的患者占15%。少数患者单独对Gly m5或6有反应或与Gly m4相关。近60% (<10岁)阳性患儿对Gly m5和6均有应答，仅14%对Gly m4有应答。大于10岁的患者对Gly m4的反应明显高于m5和m6(54% - 24%)。
Analysis of Soy Allergy Using Molecular Component Testing
DOI: https://doi.org/10.1016/j.jaci.2017.12.843 Abstract:
Soy allergy is one of the most common food allergies. The presence of IgE specific to soy component storage proteins Gly m4, m5, and m6 has been indicated as a means to improve the specific identification of systemic and local soy allergic reactions.
A retrospective review of national laboratory data was performed over samples testing for IgE to Gly m4, 5, and 6 (Phadia ImmunoCAP). Data from de-identified patient samples were compiled into risk groups based on current research utilizing the international standard cutoff of 0.35kU/L as a positive test for IgE.
Of the sample set, 46% of patients were responsive to at least one soy component. Of these, 39% of patients display response to only Gly m5 and 6, the components most indicative of a severe and systemic response to soy. Patients responsive to Gly m4 only represented 37%, and 15% were responsive to all components. Few patients were responsive to Gly m5 or 6 separately or associated with Gly m4. Nearly 60% of positive pediatric (<10Y) patients were responsive to both Gly m5 and 6 and only 14% to Gly m4 alone. Patients older than 10 years predominantly respond to Gly m4 alone over m5 and m6 only (54% to 24%).
Molecular component allergy testing represents a major step forward in assessing risk of soy allergies and constructing an appropriate medical response. A significant rate of specificity between the identification of markers for systemic and local/non-specific reactions indicates the importance of this information for patients and their families.
Dallas C. Jones, Amanda L. Hays Michelle L. Altrich PhD