한국 소아 밀 알레르기 환자에서 밀, 글루텐 및 오메가-5 글리아딘 특이 IgE의 유용성 (Usefulness of specific IgE antibody levels to wheat, gluten, and ω-5 gliadin for wheat allergy in Korean children)

서지정보

· 발행기관 : 대한 소아알레르기 호흡기학회
· 수록지 정보 : Allergy Asthma & Respiratory Disease / 4권 / 2호 / 119 ~ 125페이지
· 저자명 : 윤종서, 정경욱, 이수영

초록

Purpose: The aim of this study was to assess the clinical usefulness and added diagnostic value of specific IgE antibodies to wheat, gluten, and ω-5 gliadin in diagnosing wheat allergy and distinguishing wheat anaphylaxis.
Methods: This study included 196 children who visited Ajou University Hospital for suspicious food allergy. The subjects were divided into 2 groups: the wheat allergy (WA) and non-wheat allergy (non-WA) groups. Patients with wheat allergy were further divided into 2 subgroups according to their symptoms: the wheat allergy with anaphylaxis (WAAna) and wheat allergy without anaphylaxis (WANon-Ana) groups. Serum concentrations of total IgE and specific IgE antibodies to wheat, gluten and ω-5 gliadin were measured.
Results: The median values of specific IgE antibodies to wheat, gluten and ω-5 gliadin were significantly higher in the WA group than in the non-WA group, and the positive decision points (95% specificity) were at 3.12, 2.61, and 0.21 kUA/L, respectively. The combination of specific IgE antibodies to wheat and ω-5 gliadin resulted in the highest accuracy of 93.9% in diagnosing wheat allergy. In differentiating the WAAna group from the WANon-Ana group, only specific IgE antibody to ω-5 gliadin showed a significant difference at the optimal cutoff point of 1.56 kUA/L.
Conclusion: Our results show that the individual levels of specific IgE antibodies to wheat, gluten or ω-5 gliadin may have a considerably high accuracy in diagnosing wheat allergy and that specific IgE antibody to ω-5 gliadin may be particularly useful in predicting wheat anaphylaxis.

영어초록

Purpose: The aim of this study was to assess the clinical usefulness and added diagnostic value of specific IgE antibodies to wheat, gluten, and ω-5 gliadin in diagnosing wheat allergy and distinguishing wheat anaphylaxis.
Methods: This study included 196 children who visited Ajou University Hospital for suspicious food allergy. The subjects were divided into 2 groups: the wheat allergy (WA) and non-wheat allergy (non-WA) groups. Patients with wheat allergy were further divided into 2 subgroups according to their symptoms: the wheat allergy with anaphylaxis (WAAna) and wheat allergy without anaphylaxis (WANon-Ana) groups. Serum concentrations of total IgE and specific IgE antibodies to wheat, gluten and ω-5 gliadin were measured.
Results: The median values of specific IgE antibodies to wheat, gluten and ω-5 gliadin were significantly higher in the WA group than in the non-WA group, and the positive decision points (95% specificity) were at 3.12, 2.61, and 0.21 kUA/L, respectively. The combination of specific IgE antibodies to wheat and ω-5 gliadin resulted in the highest accuracy of 93.9% in diagnosing wheat allergy. In differentiating the WAAna group from the WANon-Ana group, only specific IgE antibody to ω-5 gliadin showed a significant difference at the optimal cutoff point of 1.56 kUA/L.
Conclusion: Our results show that the individual levels of specific IgE antibodies to wheat, gluten or ω-5 gliadin may have a considerably high accuracy in diagnosing wheat allergy and that specific IgE antibody to ω-5 gliadin may be particularly useful in predicting wheat anaphylaxis.

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