摘要
贝类是食物过敏的八大过敏原类别之一,影响全球约3%的人口。贝类过敏的发生不仅与个体的免疫系统敏感性有关,还受地理环境、食物可获得性及饮食习惯的影响。虽然甲壳类动物(如虾、螃蟹和龙虾)和软体动物(如牡蛎、贻贝和鱿鱼)被统称为贝类,但它们在生物进化、构成的过敏原分子图谱方面存在显著差异,导致了不同的过敏反应。精确识别过敏原蛋白对于贝类过敏诊断和管理至关重要,其中主要的过敏原蛋白家族包括原肌球蛋白、精氨酸激酶和血蓝蛋白等。此外,由于贝类过敏原的多样性及其与尘螨和昆虫过敏原的交叉反应性,贝类过敏的诊断和管理较为复杂,特别是原肌球蛋白和精氨酸激酶蛋白家族。目前,没有针对贝类过敏的特异性免疫治疗方法,临床管理主要依赖于回避过敏原和抗过敏药治疗等。本文通过详尽解读欧洲过敏和临床免疫学会(EAACI)发布的《过敏原组分诊断指导建议2.0》以及国内外关于贝类过敏的研究进展,突显了过敏原组分诊断技术在优化贝类过敏诊断与治疗流程中的重要作用,有效辅助临床医生准确识别常见的过敏原及交叉反应,为患者制定更个性化诊疗方案。
Shellfish,being one of the eight major food allergens,affects approximately 3%of the global population.The occurrence of shellfish allergy is not only related to the individual′s immune system sensitivity but is also influenced by geographical environment,food availability,and dietary habits.Although crustaceans(such as shrimp,crab,and lobster)and mollusks(such as oysters,mussels,and squid)are collectively referred to as shellfish,they exhibit significant differences in biological evolution and the spectrum of allergenic molecules they contain,leading to various allergic reactions.Accurate identification of allergenic proteins is crucial for the diagnosis and management of shellfish allergies,with key allergenic protein families including tropomyosin,arginine kinase,and hemocyanin.Furthermore,due to the diversity of shellfish allergens and their cross-reactivity with dust mite and insect allergens,diagnosing and managing shellfish allergies is complex,especially concerning tropomyosin and arginine kinase protein families.Currently,there are no specific immunotherapy treatments for shellfish allergies,and clinical management primarily relies on avoiding allergens and using anti-allergy medications.This article thoroughly interprets the"Molecular Allergology User′s Guide 2.0(MAUG 2.0)"published by the European Academy of Allergy and Clinical Immunology(EAACI)and the latest research on shellfish allergies both domestically and internationally.It highlights the significant role of allergen component diagnostics in optimizing the diagnostic and treatment processes for shellfish allergies,effectively assisting clinicians in accurately identifying common allergens and cross-reactions,thereby providing patients with more personalized diagnosis and treatment plans.
作者
张嘉乐
罗文婷
李奥利
孙宝清
Zhang Jiale;Luo Wenting;Li Aoli;Sun Baoqing(Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University,State Key Laboratory of Respiratory Disease,National Center for Respiratory Medicine,National Clinical Research Center for Respiratory Disease,Guangzhou Institute of Respiratory Health,Guangzhou 510120,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2024年第9期1485-1492,共8页
Chinese Journal of Preventive Medicine
基金
广州市科创委市校(院)联合基金(2023A03J0365, 202102010327)
广东省钟南山医学基金会(ZNSXS-20240015)
中国工程科技发展战略广东研究院咨询研究项目(2023-GD-04)
关键词
贝类过敏
原肌球蛋白
精氨酸激酶
交叉反应
过敏原组分诊断
Shellfish allergies
Tropomyosin
Arginine kinase
Cross-reactivity
Component-resolved diagnosis
作者简介
通信作者:孙宝清,Email:sunbaoqing@vip.163.com。
