Determinação de IgE a alérgenos alimentares por microarray (ImmunoCAP-ISAC) em pacientes com rinite alérgica
Evaluation of IgE antibodies to food allergens in patients with allergic rhinitis using microarray analysis (ImmunoCAP ISAC)
Laura Maria Lacerda Araujo; Nelson Augusto Rosário Filho
Resumo
Objetivo: Determinar a frequência de anticorpos IgE a alérgenos alimentares em pacientes com doenças alérgicas respiratórias por análise molecular. Método: Este estudo transversal incluiu 101 participantes, com idades entre 6-18 anos, com diagnóstico de rinite alérgica (89,1% com asma associada), sem história de alergia alimentar. Foi realizada análise de IgE sérica específica por ImmunoCAP ISAC, método que emprega biologia molecular para detecção de IgE a componentes alergênicos, sendo 42 alimentares e provenientes das seguintes fontes: abacaxi, aipo, amendoim, avelã, bacalhau, camarão, carpa, castanha de caju, castanha do Pará, cenoura, gergelim, kiwi, leite de vaca, maçã, ovo, pêssego, soja e trigo. Valores ≥ 0,3 ISU (unidades padronizadas do ISAC) foram considerados positivos. Utilizou-se análise estatística descritiva. Resultados: Vinte e sete (26,7%) pacientes apresentaram IgE específica a pelo menos um dos alérgenos alimentares analisados. Entre os 42 componentes alergênicos testados, 20 (47,6%) foram associados a resposta IgE em pelo menos um dos pacientes. Alérgenos com maior frequência de reatividade IgE foram: camarão (Pen a 1 15,8%, Pen i 1 16,8%, Pen m 1 16,8%) e pêssego (Pru p 3 5,9%). Conclusões: Este estudo demonstrou que a avaliação de alergia alimentar baseada em análise molecular deve considerar vários elementos, particularmente a correlação com os sintomas clínicos, e o conhecimento sobre reatividade cruzada IgE entre alérgenos das mais variadas fontes. Presença de IgE específica a determinado componente alergênico significa sensibilização, e não necessariamente alergia. Diagnóstico incorreto de alergia alimentar pode levar a tratamento inadequado, com dietas restritivas desnecessárias e prejuízo nutricional para os pacientes.
Palavras-chave
Abstract
Objective: To determine the frequency of IgE antibodies to food allergens in patients with respiratory allergic diseases using molecular analysis. Method: This cross-sectional study included 101 participants aged 6-18 years, diagnosed with allergic rhinitis (89.1% with associated asthma), and with no history of food allergy. Analysis of serum specific IgE was carried out using the ImmunoCAP ISAC method, which applies molecular biology tools to the detection of different allergens, including 42 derived from foods (pineapple, celery, peanut, hazelnut, codfish, shrimp, carp, cashew nut, Brazil nut, carrot, sesame, kiwi, cow’s milk, apple, egg, peach, soy, and wheat). Values ≥ 0.3 ISAC standardized units (ISU) were considered to be positive. Descriptive statistical analysis was used. Results: Twenty seven (26.7%) patients presented specific IgE to at least one of the food allergens analyzed. Among the 42 allergic components tested, 20 (47.6%) were associated with IgE responses in at least one patient. The allergens with the highest frequencies of IgE reactivity were shrimp (Pen a 1 15.8%, Pen i 1 16.8%, Pen m 1 16.8%) and peach (Pru p 3 5.9%). Conclusions: The present study showed that molecular-based evaluation of food allergies should take several elements into consideration, particularly the correlation with clinical symptoms and the knowledge available on IgE cross-reactivity among allergens from different sources. Presence of specific IgE to one allergen means sensitization, but not necessarily allergy. Misdiagnosis of food allergies may lead to inappropriate treatment, with unnecessarily restrictive diets which could affect the nutritional status of patients.
Keywords
References
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Submitted date:
10/24/2013
Accepted date:
11/25/2013
