近日,，來自墨爾本大學(xué)等處的研究人員發(fā)現(xiàn)了一種可以精確檢測花生過敏的方法，這種新型的檢測方法比一般傳統(tǒng)的檢測方法更為簡便有效,，而且可以最大限度的減少過度診斷給患者帶來的傷害,，目前,，主要是用口部食物的檢測方法（oral food challenge）來檢測花生過敏癥，這種方法受到一定程度的限制,，而且耗時耗力，對患者可以帶來明顯的過敏性反應(yīng),。
研究者的新型檢測方法是用花生蛋白Arah2來進(jìn)行兩步的篩查,，首先進(jìn)行的是血液檢測，其次用Arah2方法檢測,，這種方法的準(zhǔn)確性比較高,，這種新型的兩步法比傳統(tǒng)的口腔檢測方法可以減小四倍的所用檢測物。研究者Thanh Dang表示,，這種方法有眾多優(yōu)勢,，不僅可以減少檢測物的量，而且可以阻止不必要的檢測風(fēng)險,，助理教授Katie Allen表示這種新型方法可以減少衛(wèi)生系統(tǒng)的負(fù)擔(dān),。
近年來，因為人類對很多食物敏感性的增加,，導(dǎo)致眾多的過敏性事件的發(fā)生,，給食品檢測以及過敏檢測帶來了很多困難，如今這種新型的方法可以幫助緩解目前這種問題,，由于漫長的等待時間導(dǎo)致醫(yī)生會面對很困難的任務(wù),，就是很困難來評估食品過敏性的陽性皮膚測試實驗,，這樣有時候會判斷錯誤。Allen博士表示,，臨床上對花生攝入有明顯反應(yīng)的癥狀即可直接認(rèn)為是花生過敏癥,，但是很多時候，臨床上表現(xiàn)并不明顯或者小孩并沒有暴露于食品之中,，對于這種情況來說,，診斷過敏就比較復(fù)雜和麻煩了。
研究者表示Arah2兩步檢測法可以被用于對食品過敏高風(fēng)險的孩子們,，比如濕疹和其它食物過敏等,，或者是從來不吃花生的孩子和有食物過敏家族史的人。研究者相關(guān)的研究成果刊登在了國際雜志Journal of Allergy and Clinical Immunology上,。
（生物谷：T.Shen編譯）
doi:10.1016/j.jaci.2012.01.056
PMC:
PMID:
Increasing the accuracy of peanut allergy diagnosis by using Arah2
Thanh D. Dang, BBiomedSc (Hons)a, b, Mimi Tang, MBBS, PhD, FRACP, FRCPA, FAAAAIa, b, c, Sharon Choo, MBBS, FRACP, FRCPAc, e, Paul V. Licciardi, PhDa, b, Jennifer J. Koplin, PhDa, b, Pamela E. Martin, BBiomedSc (Hons)a, b, Tina Tan, BSca, b, Lyle C. Gurrin, PhDa, d, Anne-Louise Ponsonby, BMedSc, MBBS, PhD, FAFPHM, FRACPa, b, Dean Tey, MBBS, FRACPa, c, Marnie Robinson, MBBS, FRACPa, c, Shyamali C. Dharmage, MBBS, MSc, MD, PhDa, d, Katrina J. Allen, BMedSc, MBBS, FRACP, PhDa, b, c, , , HealthNuts study
Background Measurement of whole peanut-specific IgE (sIgE) is often used to confirm sensitization but does not reliably predict allergy. Ara h 2 is the dominant peanut allergen detected in 90% to 100% of patients with peanut allergy and could help improve diagnosis.
Objectives We sought to determine whether Ara h 2 testing might improve the accuracy of diagnosing peanut allergy and therefore circumvent the need for an oral food challenge (OFC). Methods Infants from the population-based HealthNuts study underwent skin prick tests to determine peanut sensitization and subsequently underwent a peanut OFC to confirm allergy status. In a stratified random sample of 200 infants (100 with peanut allergy and 100 with peanut tolerance), whole peanut sIgE and Ara h 2 sIgE levels were quantified by using fluorescence enzyme immunoassay.
Results By using the previously published 95% positive predictive value of 15 kUA/L for whole peanut sIgE, a corresponding specificity of 98% (95% CI, 93% to 100%) was found in this study cohort. At the equivalent specificity of 98%, the sensitivity of Ara h 2 sIgE is 60% (95% CI, 50% to 70%), correctly identifying 60% of subjects with true peanut allergy compared with only 26% correctly identified by using whole peanut sIgE. We report that when using a combined approach of plasma sIgE testing for whole peanut followed by Ara h 2 for the diagnosis of peanut allergy, the number of OFCs required is reduced by almost two thirds.
Conclusion Ara h 2 plasma sIgE test levels provide higher diagnostic accuracy than whole peanut plasma sIgE levels and could be considered a new diagnostic tool to distinguish peanut allergy from peanut tolerance, which might reduce the need for an OFC.
