Wartość diagnostyczna oznaczeń specyficznych IgG w alergii i nietolerancji pokarmowej
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Opublikowane:
mar 22, 2013
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przeciwciała IgG, alergia pokarmowa, nietolerancja pokarmowa
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Abstrakt
Rozpoznanie alergii pokarmowej opiera się przede wszystkim na wywiadzie i dokładnym badaniu fizykalnym. Kliniczne lub laboratoryjne badania dodatkowe służą jedynie do potwierdzenia diagnozy. Standardowe techniki badawcze obejmują punktowe testy skórne i testy in vitro dla specyficznych przeciwciał IgE oraz doustne próby prowokacyjne. Nie ma natomiast wiarygodnych dowodów na to, że pomiar IgG jest przydatny w diagnostyce alergii lub nietolerancji, ani na to, że obecność tych przeciwciał wywołuje jakieś objawy. W obliczu braku znaczenia klinicznego wspomnianych oznaczeń i możliwych szkód wynikających z ich wykorzystania, organizacje alergologiczne i immunologiczne na całym świecie odradzają stosowanie testów IgG w diagnostyce nietolerancji pokarmowej.
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Modrzyński , M., & Modrzyńska , K. (2013). Wartość diagnostyczna oznaczeń specyficznych IgG w alergii i nietolerancji pokarmowej. Alergoprofil, 9(1), 11-15. Pobrano z https://journalsmededu.pl/index.php/alergoprofil/article/view/752
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Bibliografia
1. Ahrens B., Lopes de Oliveira L.C., Grabenhenrich L., Schulz G., Niggemann B., Wahn U., Beyer K.: Individual cow’s milk allergens as prognostic markers for tolerance development? Clin. Exp. Allergy 2012, 42(11): 1630-1637.
2. Arroyave Hernández C.M., Echavarría Pinto M., Hernández Montiel H.L.: Food allergy mediated by IgG antibodies associated with migraine in adults. Rev. Alerg. Mex. 2007, 54(5): 162-168.
3. Barnes R.M.R.: IgG and IgA antibodies to dietary antigens in food allergy and intolerance. Clin. Exp. Allergy 1995, 25(Suppl. 1): 7-9.
4. Bock S.A., Buckley J., Holst A., May C.D.: Proper use of skin tests with food extracts in diagnosis of hypersensitivity to food in children. Clin. Allergy 1977, 7: 375-383.
5. Burks A.W., Williams L.W., Casteel H.B., Fiedorek S.C., Connaughton C.A.: Antibody response to milk proteins in patients with milk-protein intolerance documented by challenge. J. Allergy Clin. Immunol. 1990, 85: 921-927.
6. Caubet J.C., Bencharitiwong R., Moshier E., Godbold J.H., Sampson H.A., Nowak-Węgrzyn A.: Significance of ovomucoid- and ovalbumin-specific IgE/IgG(4) ratios in egg allergy. J. Allergy Clin. Immunol. 2012, 129(3): 739-747.
7. Dannaeus A., Johansson S.G., Foucard T., Ohman S.: Clinical and immunological aspects of food allergy in childhood. I. Estimation of IgG, IgA and IgE antibodies to food antigens in children with food allergy and atopic dermatitis. Acta Paediatr. Scand. 1977, 66(1): 31-37.
8. Geroldinger-Simic M., Zelniker T., Aberer W., Ebner C., Egger C., Greiderer A., Prem N., Lidholm J., Ballmer-Weber B.K., Vieths S., Bohle B.: Birch pollen-related food allergy: clinical aspects and the role of allergen-specific IgE and IgG4 antibodies. J. Allergy Clin. Immunol. 2011, 127(3): 616-622.
9. Hochwallner H., Schulmeister U., Swoboda I., Twaroch T.E., Vogelsang H., Kazemi-Shirazi L., Kundi M., Balic N., Quirce S., Rumpold H., Fröschl R., Horak F., Tichatschek B., Stefanescu C.L., Szépfalusi Z., Papadopoulos N.G., Mari A., Ebner C., Pauli G., Valenta R., Spitzauer S.: Patients suffering from non-IgE-mediated cow’s milk protein intolerance cannot be diagnosed based on IgG subclass or IgA responses to milk allergens. Allergy 2011, 66(9): 1201-1207.
10. Husby S., Schultz Larsen F., Svehag S.E.: IgG subclass antibodies to dietary antigens in atopic dermatitis. Acta Derm. Venereol. Suppl. (Stockh.) 1989, 144: 88-92.
11. Jenkins M., Vickers A.: Unreliability of IgE/IgG4 antibody testing as a diagnostic tool in food intolerance. Clin. Exp. Allergy 1998, 28: 1526-1529.
12. Johansson S.G.O., Dannaeus A., Lilja G.: The relevance of anti-food antibodies for the diagnosis of food allergy. Ann. Allergy 1984, 53: 665-672.
13. Kemeny D.M., Urbanek R., Amlot P.L., Ciclitira P.J., Richards D., Lessof M.H.: Sub-class of IgG in allergic disease I. IgG sub-class antibodies in immediate and non-immediate food allergy. Clin. Allergy 1986, 16: 571-581.
14. Kruszewski J., Raczka A., Kłos M., Wiktor-Jedrzejczak W.: High serum levels of allergen specific IgG-4 (asIgG-4) for common food allergens in healthy blood donors. Arch. Immunol. Ther. Exp. (Warsz.) 1994, 42(4): 259-261.
15. Samoliński B., Raciborski F., Tomaszewska A. et al.: Częstość występowania alergii w Polsce – program ECAP. Alergoprofil 2007, 3: 26-28.
16. Sheah-Min Y., Choon-Kook S.: The relevance of specific serum IgG, IgG4 and IgE in the determination of shrimp and crab allergies in Malaysian allergic rhinitis patients. Asian Pac. J. Allergy Immunol. 2001, 19(1): 7-10.
17. Shek L.P., Bardina L., Castro R., Sampson H.A., Beyer K.: Humoral and cellular responses to cow milk proteins in patients with milkinduced IgE-mediated and non-IgE mediated disorders. Allergy 2005, 60: 912-919.
18. Stiening H., Szczepanski R., von Muhlendahl K.E., Kalveram C.: Neurodermitis und Nahrungsmittelallergie. Klinische Relevanz von Testverfahren. Monatsschr. Kinderheilkd. 1990, 138: 803-807.
19. Zimmer A., Bexley J., Halliwell R.E., Mueller R.S.: Food allergen-specific serum IgG and IgE before and after elimination diets in allergic dogs. Vet. Immunol. Immunopathol. 2011, 144(3-4): 442-447.
20. http://www.ake-nutrition.at/ uploads/media/IgG_4_
toFoods_EAACIreport_ ALLERGY6_2008.pdf.
21. http://www.aaaai.org/ask-the-expert/usefulness-ofmeasurements-of-IgG-antibody.aspx.
22. http://guidelines.gov/content.aspx?id=13114.
23. http://www.allergysa.org/pdfs/intolerance_tests.pdf.
24. http://www.allergy.org.au/health-professionals/papers/unorthodox-techniques-for-diagnosis-and-treatment.
2. Arroyave Hernández C.M., Echavarría Pinto M., Hernández Montiel H.L.: Food allergy mediated by IgG antibodies associated with migraine in adults. Rev. Alerg. Mex. 2007, 54(5): 162-168.
3. Barnes R.M.R.: IgG and IgA antibodies to dietary antigens in food allergy and intolerance. Clin. Exp. Allergy 1995, 25(Suppl. 1): 7-9.
4. Bock S.A., Buckley J., Holst A., May C.D.: Proper use of skin tests with food extracts in diagnosis of hypersensitivity to food in children. Clin. Allergy 1977, 7: 375-383.
5. Burks A.W., Williams L.W., Casteel H.B., Fiedorek S.C., Connaughton C.A.: Antibody response to milk proteins in patients with milk-protein intolerance documented by challenge. J. Allergy Clin. Immunol. 1990, 85: 921-927.
6. Caubet J.C., Bencharitiwong R., Moshier E., Godbold J.H., Sampson H.A., Nowak-Węgrzyn A.: Significance of ovomucoid- and ovalbumin-specific IgE/IgG(4) ratios in egg allergy. J. Allergy Clin. Immunol. 2012, 129(3): 739-747.
7. Dannaeus A., Johansson S.G., Foucard T., Ohman S.: Clinical and immunological aspects of food allergy in childhood. I. Estimation of IgG, IgA and IgE antibodies to food antigens in children with food allergy and atopic dermatitis. Acta Paediatr. Scand. 1977, 66(1): 31-37.
8. Geroldinger-Simic M., Zelniker T., Aberer W., Ebner C., Egger C., Greiderer A., Prem N., Lidholm J., Ballmer-Weber B.K., Vieths S., Bohle B.: Birch pollen-related food allergy: clinical aspects and the role of allergen-specific IgE and IgG4 antibodies. J. Allergy Clin. Immunol. 2011, 127(3): 616-622.
9. Hochwallner H., Schulmeister U., Swoboda I., Twaroch T.E., Vogelsang H., Kazemi-Shirazi L., Kundi M., Balic N., Quirce S., Rumpold H., Fröschl R., Horak F., Tichatschek B., Stefanescu C.L., Szépfalusi Z., Papadopoulos N.G., Mari A., Ebner C., Pauli G., Valenta R., Spitzauer S.: Patients suffering from non-IgE-mediated cow’s milk protein intolerance cannot be diagnosed based on IgG subclass or IgA responses to milk allergens. Allergy 2011, 66(9): 1201-1207.
10. Husby S., Schultz Larsen F., Svehag S.E.: IgG subclass antibodies to dietary antigens in atopic dermatitis. Acta Derm. Venereol. Suppl. (Stockh.) 1989, 144: 88-92.
11. Jenkins M., Vickers A.: Unreliability of IgE/IgG4 antibody testing as a diagnostic tool in food intolerance. Clin. Exp. Allergy 1998, 28: 1526-1529.
12. Johansson S.G.O., Dannaeus A., Lilja G.: The relevance of anti-food antibodies for the diagnosis of food allergy. Ann. Allergy 1984, 53: 665-672.
13. Kemeny D.M., Urbanek R., Amlot P.L., Ciclitira P.J., Richards D., Lessof M.H.: Sub-class of IgG in allergic disease I. IgG sub-class antibodies in immediate and non-immediate food allergy. Clin. Allergy 1986, 16: 571-581.
14. Kruszewski J., Raczka A., Kłos M., Wiktor-Jedrzejczak W.: High serum levels of allergen specific IgG-4 (asIgG-4) for common food allergens in healthy blood donors. Arch. Immunol. Ther. Exp. (Warsz.) 1994, 42(4): 259-261.
15. Samoliński B., Raciborski F., Tomaszewska A. et al.: Częstość występowania alergii w Polsce – program ECAP. Alergoprofil 2007, 3: 26-28.
16. Sheah-Min Y., Choon-Kook S.: The relevance of specific serum IgG, IgG4 and IgE in the determination of shrimp and crab allergies in Malaysian allergic rhinitis patients. Asian Pac. J. Allergy Immunol. 2001, 19(1): 7-10.
17. Shek L.P., Bardina L., Castro R., Sampson H.A., Beyer K.: Humoral and cellular responses to cow milk proteins in patients with milkinduced IgE-mediated and non-IgE mediated disorders. Allergy 2005, 60: 912-919.
18. Stiening H., Szczepanski R., von Muhlendahl K.E., Kalveram C.: Neurodermitis und Nahrungsmittelallergie. Klinische Relevanz von Testverfahren. Monatsschr. Kinderheilkd. 1990, 138: 803-807.
19. Zimmer A., Bexley J., Halliwell R.E., Mueller R.S.: Food allergen-specific serum IgG and IgE before and after elimination diets in allergic dogs. Vet. Immunol. Immunopathol. 2011, 144(3-4): 442-447.
20. http://www.ake-nutrition.at/ uploads/media/IgG_4_
toFoods_EAACIreport_ ALLERGY6_2008.pdf.
21. http://www.aaaai.org/ask-the-expert/usefulness-ofmeasurements-of-IgG-antibody.aspx.
22. http://guidelines.gov/content.aspx?id=13114.
23. http://www.allergysa.org/pdfs/intolerance_tests.pdf.
24. http://www.allergy.org.au/health-professionals/papers/unorthodox-techniques-for-diagnosis-and-treatment.