变应原组分诊断及肽段微阵列技术在牛奶过敏特异性诊断中的应用
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摘要
牛奶蛋白过敏(cow’s milk allergy, CMA)是儿童最常见的食物过敏之一,大多数CMA患者可随年龄增长对牛奶及牛奶制品产生耐受,约60%CMA免疫学机制为IgE介导。酪蛋白、β-乳球蛋白、α-乳清蛋白是牛奶主要致敏组分。相较于传统的应用天然变应原提取物进行特异性IgE检测,重组或纯化的牛奶变应原组分特异性IgE检测可更精确的诊断CMA及预测其自然进程。变应原组分氨基酸序列的确定使得IgE结合肽段的识别成为可能,基于变应原肽段微阵列技术可用于诊断CMA、预测自然进程及特异性免疫治疗的疗效和安全性。本综述就IgE介导CMA特异性诊断尤其是变应原组分诊断及肽段微阵列技术在CMA特异性诊断中的应用进行总结,旨在为临床工作提供参考。
Cow's milk allergy(CMA) is one of the most common food allergic reactions, especially during childhood. Fortunately, the majority of children with CMA develop clinical tolerance with age. About 60% of CMA is IgE-mediated. The major allergens of cow milk are caseins, α-lactalbumin, and β-lactoglobulin. Compared to traditional specific IgE detection using crude cow milk extracts, component resolved diagnosis(CRD, allergenic component sIgE detections) using purified or recombinant allergens can achieve in accurate diagnosis and prediction of the natural history of CMA. Peptide microarray can be used to detect sIgE against allergen peptide epitopes, based on the determination of amino acid sequence of allergens. Peptide microarray can be used in the diagnosis of CMA, prediction of the natural history and the efficacy and safety of oral immunotherapy for CMA patients. Recent applications of CRD and peptide microarray in the field of cow's milk allergy were focused in this review.
Cow's milk allergy(CMA) is one of the most common food allergic reactions, especially during childhood. Fortunately, the majority of children with CMA develop clinical tolerance with age. About 60% of CMA is IgE-mediated. The major allergens of cow milk are caseins, α-lactalbumin, and β-lactoglobulin. Compared to traditional specific IgE detection using crude cow milk extracts, component resolved diagnosis(CRD, allergenic component sIgE detections) using purified or recombinant allergens can achieve in accurate diagnosis and prediction of the natural history of CMA. Peptide microarray can be used to detect sIgE against allergen peptide epitopes, based on the determination of amino acid sequence of allergens. Peptide microarray can be used in the diagnosis of CMA, prediction of the natural history and the efficacy and safety of oral immunotherapy for CMA patients. Recent applications of CRD and peptide microarray in the field of cow's milk allergy were focused in this review.
引文
[1] Schoemaker AA,Sprikkelman AB,Grimshaw KE,et al.Incidence and natural history of challenge-proven cow’s milk allergy in European children--EuroPrevall birth cohort[J].Allergy,2015,70:963-972.
[2] Sampson HA,Aceves S,Bock SA,et al.Food allergy:a practice parameter update-2014[J].J Allergy Clin Immunol,2014,134:1016-1025.
[3] Nwaru BI,Hickstein L,Panesar SS,et al.Prevalence of common food allergies in Europe:a systematic review and meta-analysis[J].Allergy,2014,69:992-1007.
[4] Yang M,Tan M,Wu J,et al.Prevalence,characteristics,and outcome of cow’s milk protein allergy in Chinese infants:A Population-Based Survey[2018-11-19].JPEN J Parenter Enteral Nutr.2018,10.1002/jpen.1472.doi:10.1002/jpen.1472.
[5] Kattan JD,Cocco RR,Jarvinen KM.Milk and soy allergy[J].Pediatr Clin North Am,2011,58:407-426.
[6] Skripak JM,Matsui EC,Mudd K,et al.The natural history of IgE-mediated cow’s milk allergy[J].J Allergy Clin Immunol,2007,120:1172-1177.
[7] Luyt D,Ball H,Makwana N,et al.BSACI guideline for the diagnosis and management of cow’s milk allergy[J].Clin Exp Allergy,2014,44:42-672.
[8] Tsabouri S,Douros K,Priftis KN.Cow’s milk allergenicity[J].Endocr Metab Immune Disord Drug Targets,2014,14:16-26.
[9] Fiocchi A,Dahdah L,Albarini M,et al.Cow’s milk allergy in children and adults[J].Chem Immunol Allergy,2015,101:114-123.
[10] Bloom KA,Huang FR,Bencharitiwong R,et al.Effect of heat treatment on milk and egg proteins allergenicity[J].Pediatr Allergy Immunol,2014,25:740-746.
[11] Bijl E,van Valenberg HJ,Huppertz T,et al.Protein,casein,and micellar salts in milk:current content and historical perspectives[J].J Dairy Sci,2013,96:5455-5464.
[12] Spuergin P,Walter M,Schiltz E,et al.Allergenicity of alpha-caseins from cow,sheep,and goat[J].Allergy,1997,52:293-298.
[13] Cases B,Garcia-Ara C,Boyano MT,et al.Phosphorylation reduces the allergenicity of cow casein in children with selective allergy to goat and sheep milk[J].J Investig Allergol Clin Immunol,2011,21:398-400.
[14] Stanic D,Monogioudi E,Dilek E,et al.Digestibility and allergenicity assessment of enzymatically crosslinked beta-casein[J].Mol Nutr Food Res,2010,54:1273-1284.
[15] Hochwallner H,Schulmeister U,Swoboda I,et al.Visualization of clustered IgE epitopes on alpha-lactalbumin[J].J Allergy Clin Immunol,2010,125:1279-1285.
[16] Restani P,Ballabio C,Tripodi S,et al.Meat allergy[J].Curr Opin Allergy Clin Immunol,2009,9:265-269.
[17] Restani P,Ballabio C,Cattaneo A,et al.Characterization of bovine serum albumin epitopes and their role in allergic reactions[J].Allergy,2004,59(Suppl 78):21-24.
[18] Vicente-Serrano J,Caballero ML,Rodriguez-Perez R,et al.Sensitization to serum albumins in children allergic to cow’s milk and epithelia[J].Pediatr Allergy Immunol,2007,18:503-507.
[19] Sampson HA.Utility of food-specific IgE concentrations in predicting symptomatic food allergy[J].J Allergy Clin Immunol,2001,107:891-896.
[20] Garcia-Ara MC,Boyano-Martinez MT,Diaz-Pena JM,et al.Cow’s milk-specific immunoglobulin E levels as predictors of clinical reactivity in the follow-up of the cow’s milk allergy infants[J].Clin Exp Allergy,2004,34:866-870.
[21] van der Gugten AC,den Otter M,Meijer Y,et al.Usefulness of specific IgE levels in predicting cow’s milk allergy[J].J Allergy Clin Immunol,2008,121:531-533.
[22] Valenta R,Linhart B,Swoboda I,et al.Recombinant allergens for allergen-specific immunotherapy:10 years anniversary of immunotherapy with recombinant allergens[J].Allergy,2011,66:775-783.
[23] Cases B,Pastor-Vargas C,Perez-Gordo M.Allergen extraction and purification from natural products:main chromatographic techniques[J].Methods Mol Biol,2017,1592:13-22.
[24] Liu C,Willison LN,Sathe SK.Recombinant allergen production in E.Coli[J].Methods Mol Biol,2017,1592:23-45.
[25] Chapman MD,Smith AM,Vailes LD,et al.Recombinant allergens for diagnosis and therapy of allergic disease[J].J Allergy Clin Immunol,2000,106:409-418.
[26] Hochwallner H,Schulmeister U,Swoboda I,et al.Cow’s milk allergy:from allergens to new forms of diagnosis,therapy and prevention[J].Methods,2014,66:22-33.
[27] Sanz ML,Blazquez AB,Garcia BE.Microarray of allergenic component-based diagnosis in food allergy[J].Curr Opin Allergy Clin Immunol,2011,11:204-209.
[28] Deng S,Yin J.Mugwort pollen-related food allergy:Lipid transfer protein sensitization and correlation with the severity of allergic reactions in a Chinese population[J].Allergy Asthma Immunol Res,2019,1:16-128.
[29] Ahrens B,Lopes de Oliveira LC,Grabenhenrich L,et al.Individual cow’s milk allergens as prognostic markers for tolerance development?[J].Clin Exp Allergy,2012,42:1630-1637.
[30] Ford LS,Bloom KA,Nowak-Wegrzyn AH,et al.Basophil reactivity,wheal size,and immunoglobulin levels distinguish degrees of cow’s milk tolerance[J].J Allergy Clin Immunol,2013,131:180-186.
[31] Caubet JC,Nowak-Wegrzyn A,Moshier E,et al.Utility of casein-specific IgE levels in predicting reactivity to baked milk[J].J Allergy Clin Immunol,2013,131:222-224.
[32] Ahrens B,Niggemann E,Wahn E,et al.Positive reactions to placebo in children undergoing double-blind,placebo-controlled food challenge[J].Clin Exp Allergy,2014,44:572-578.
[33] Hochwallner H,Schulmeister U,Swoboda I,et al.Microarray and allergenic activity assessment of milk allergens[J].Clin Exp Allergy,2010,40:1809-1818.
[34] Schulmeister U,Hochwallner H,Swoboda I,et al.Cloning,expression,and mapping of allergenic determinants of alphaS1-casein,a major cow’s milk allergen[J].J Immunol,2009,182:7019-7029.
[35] Han N,Jarvinen KM,Cocco RR,et al.Identification of amino acids critical for IgE-binding to sequential epitopes of bovine kappa-casein and the similarity of these epitopes to the corresponding human kappa-casein sequence[J].Allergy,2008,63:198-204.
[36] Valenta R,Ferreira F,Focke-Tejkl M,et al.From allergen genes to allergy vaccines[J].Annu Rev Immunol,2010,28:211-241.
[37] Fiocchi A,Bouygue GR,Albarini M,et al.Molecular diagnosis of cow’s milk allergy[J].Curr Opin Allergy Clin Immunol,2011,11:216-221.
[38] Cerecedo I,Zamora J,Shreffler WG,et al.Mapping of the IgE and IgG4 sequential epitopes of milk allergens with a peptide microarray-based immunoassay[J].J Allergy Clin Immunol,2008,122:589-594.
[39] Wang J,Lin J,Bardina L,et al.Correlation of IgE/IgG4 milk epitopes and affinity of milk-specific IgE antibodies with different phenotypes of clinical milk allergy[J].J Allergy Clin Immunol,2010,125:695-702.
[40] Savilahti EM,Rantanen V,Lin JS,et al.Early recovery from cow’s milk allergy is associated with decreasing IgE and increasing IgG4 binding to cow’s milk epitopes[J].J Allergy Clin Immunol,2010,125:1315-1321.
[41] Martinez-Botas J,Rodriguez-Alvarez M,Cerecedo I,et al.Identification of novel peptide biomarkers to predict safety and efficacy of cow’s milk oral immunotherapy by peptide microarray[J].Clin Exp Allergy,2015,45:1071-1084.
[42] Suarez-Farinas M,Suprun M,Chang HL,et al.Predicting development of sustained unresponsiveness to milk oral immunotherapy using epitope-specific antibody binding profiles[J].J Allergy Clin Immunol,2018,143:1038-1046.
[2] Sampson HA,Aceves S,Bock SA,et al.Food allergy:a practice parameter update-2014[J].J Allergy Clin Immunol,2014,134:1016-1025.
[3] Nwaru BI,Hickstein L,Panesar SS,et al.Prevalence of common food allergies in Europe:a systematic review and meta-analysis[J].Allergy,2014,69:992-1007.
[4] Yang M,Tan M,Wu J,et al.Prevalence,characteristics,and outcome of cow’s milk protein allergy in Chinese infants:A Population-Based Survey[2018-11-19].JPEN J Parenter Enteral Nutr.2018,10.1002/jpen.1472.doi:10.1002/jpen.1472.
[5] Kattan JD,Cocco RR,Jarvinen KM.Milk and soy allergy[J].Pediatr Clin North Am,2011,58:407-426.
[6] Skripak JM,Matsui EC,Mudd K,et al.The natural history of IgE-mediated cow’s milk allergy[J].J Allergy Clin Immunol,2007,120:1172-1177.
[7] Luyt D,Ball H,Makwana N,et al.BSACI guideline for the diagnosis and management of cow’s milk allergy[J].Clin Exp Allergy,2014,44:42-672.
[8] Tsabouri S,Douros K,Priftis KN.Cow’s milk allergenicity[J].Endocr Metab Immune Disord Drug Targets,2014,14:16-26.
[9] Fiocchi A,Dahdah L,Albarini M,et al.Cow’s milk allergy in children and adults[J].Chem Immunol Allergy,2015,101:114-123.
[10] Bloom KA,Huang FR,Bencharitiwong R,et al.Effect of heat treatment on milk and egg proteins allergenicity[J].Pediatr Allergy Immunol,2014,25:740-746.
[11] Bijl E,van Valenberg HJ,Huppertz T,et al.Protein,casein,and micellar salts in milk:current content and historical perspectives[J].J Dairy Sci,2013,96:5455-5464.
[12] Spuergin P,Walter M,Schiltz E,et al.Allergenicity of alpha-caseins from cow,sheep,and goat[J].Allergy,1997,52:293-298.
[13] Cases B,Garcia-Ara C,Boyano MT,et al.Phosphorylation reduces the allergenicity of cow casein in children with selective allergy to goat and sheep milk[J].J Investig Allergol Clin Immunol,2011,21:398-400.
[14] Stanic D,Monogioudi E,Dilek E,et al.Digestibility and allergenicity assessment of enzymatically crosslinked beta-casein[J].Mol Nutr Food Res,2010,54:1273-1284.
[15] Hochwallner H,Schulmeister U,Swoboda I,et al.Visualization of clustered IgE epitopes on alpha-lactalbumin[J].J Allergy Clin Immunol,2010,125:1279-1285.
[16] Restani P,Ballabio C,Tripodi S,et al.Meat allergy[J].Curr Opin Allergy Clin Immunol,2009,9:265-269.
[17] Restani P,Ballabio C,Cattaneo A,et al.Characterization of bovine serum albumin epitopes and their role in allergic reactions[J].Allergy,2004,59(Suppl 78):21-24.
[18] Vicente-Serrano J,Caballero ML,Rodriguez-Perez R,et al.Sensitization to serum albumins in children allergic to cow’s milk and epithelia[J].Pediatr Allergy Immunol,2007,18:503-507.
[19] Sampson HA.Utility of food-specific IgE concentrations in predicting symptomatic food allergy[J].J Allergy Clin Immunol,2001,107:891-896.
[20] Garcia-Ara MC,Boyano-Martinez MT,Diaz-Pena JM,et al.Cow’s milk-specific immunoglobulin E levels as predictors of clinical reactivity in the follow-up of the cow’s milk allergy infants[J].Clin Exp Allergy,2004,34:866-870.
[21] van der Gugten AC,den Otter M,Meijer Y,et al.Usefulness of specific IgE levels in predicting cow’s milk allergy[J].J Allergy Clin Immunol,2008,121:531-533.
[22] Valenta R,Linhart B,Swoboda I,et al.Recombinant allergens for allergen-specific immunotherapy:10 years anniversary of immunotherapy with recombinant allergens[J].Allergy,2011,66:775-783.
[23] Cases B,Pastor-Vargas C,Perez-Gordo M.Allergen extraction and purification from natural products:main chromatographic techniques[J].Methods Mol Biol,2017,1592:13-22.
[24] Liu C,Willison LN,Sathe SK.Recombinant allergen production in E.Coli[J].Methods Mol Biol,2017,1592:23-45.
[25] Chapman MD,Smith AM,Vailes LD,et al.Recombinant allergens for diagnosis and therapy of allergic disease[J].J Allergy Clin Immunol,2000,106:409-418.
[26] Hochwallner H,Schulmeister U,Swoboda I,et al.Cow’s milk allergy:from allergens to new forms of diagnosis,therapy and prevention[J].Methods,2014,66:22-33.
[27] Sanz ML,Blazquez AB,Garcia BE.Microarray of allergenic component-based diagnosis in food allergy[J].Curr Opin Allergy Clin Immunol,2011,11:204-209.
[28] Deng S,Yin J.Mugwort pollen-related food allergy:Lipid transfer protein sensitization and correlation with the severity of allergic reactions in a Chinese population[J].Allergy Asthma Immunol Res,2019,1:16-128.
[29] Ahrens B,Lopes de Oliveira LC,Grabenhenrich L,et al.Individual cow’s milk allergens as prognostic markers for tolerance development?[J].Clin Exp Allergy,2012,42:1630-1637.
[30] Ford LS,Bloom KA,Nowak-Wegrzyn AH,et al.Basophil reactivity,wheal size,and immunoglobulin levels distinguish degrees of cow’s milk tolerance[J].J Allergy Clin Immunol,2013,131:180-186.
[31] Caubet JC,Nowak-Wegrzyn A,Moshier E,et al.Utility of casein-specific IgE levels in predicting reactivity to baked milk[J].J Allergy Clin Immunol,2013,131:222-224.
[32] Ahrens B,Niggemann E,Wahn E,et al.Positive reactions to placebo in children undergoing double-blind,placebo-controlled food challenge[J].Clin Exp Allergy,2014,44:572-578.
[33] Hochwallner H,Schulmeister U,Swoboda I,et al.Microarray and allergenic activity assessment of milk allergens[J].Clin Exp Allergy,2010,40:1809-1818.
[34] Schulmeister U,Hochwallner H,Swoboda I,et al.Cloning,expression,and mapping of allergenic determinants of alphaS1-casein,a major cow’s milk allergen[J].J Immunol,2009,182:7019-7029.
[35] Han N,Jarvinen KM,Cocco RR,et al.Identification of amino acids critical for IgE-binding to sequential epitopes of bovine kappa-casein and the similarity of these epitopes to the corresponding human kappa-casein sequence[J].Allergy,2008,63:198-204.
[36] Valenta R,Ferreira F,Focke-Tejkl M,et al.From allergen genes to allergy vaccines[J].Annu Rev Immunol,2010,28:211-241.
[37] Fiocchi A,Bouygue GR,Albarini M,et al.Molecular diagnosis of cow’s milk allergy[J].Curr Opin Allergy Clin Immunol,2011,11:216-221.
[38] Cerecedo I,Zamora J,Shreffler WG,et al.Mapping of the IgE and IgG4 sequential epitopes of milk allergens with a peptide microarray-based immunoassay[J].J Allergy Clin Immunol,2008,122:589-594.
[39] Wang J,Lin J,Bardina L,et al.Correlation of IgE/IgG4 milk epitopes and affinity of milk-specific IgE antibodies with different phenotypes of clinical milk allergy[J].J Allergy Clin Immunol,2010,125:695-702.
[40] Savilahti EM,Rantanen V,Lin JS,et al.Early recovery from cow’s milk allergy is associated with decreasing IgE and increasing IgG4 binding to cow’s milk epitopes[J].J Allergy Clin Immunol,2010,125:1315-1321.
[41] Martinez-Botas J,Rodriguez-Alvarez M,Cerecedo I,et al.Identification of novel peptide biomarkers to predict safety and efficacy of cow’s milk oral immunotherapy by peptide microarray[J].Clin Exp Allergy,2015,45:1071-1084.
[42] Suarez-Farinas M,Suprun M,Chang HL,et al.Predicting development of sustained unresponsiveness to milk oral immunotherapy using epitope-specific antibody binding profiles[J].J Allergy Clin Immunol,2018,143:1038-1046.