第四和五章：食品过敏及过敏原信息课件

,单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Food Sensitivities,食品过敏,Food Sensitivities 食品过敏,MAIN CONTENTS,主要内容,OVERVIEW OF FOOD ADEVERSE REACTION,食品不良反应的概述,SYMPTOMS OF ADVERSE FOOD REACTIONS,食品过敏反应的症状,MAIN CONTENTS 主要内容OVERVIEW OF,PREVALENCE,发病率,FOOD ALLERGENS,食品过敏原,FOOD ADDITIVES,食品添加剂,PREVALENCE发病率,OVERVIEW OF ADVERSE FOOD REACTION,食品不良反应的概述,OVERVIEW OF ADVERSE FOOD REAC,第四和五章：食品过敏及过敏原信息课件,toxic food reactions,食品毒性反应,A classical toxic food reaction is scombroid fish poisoning, due to large amounts of histamine,鲭亚目鱼组胺中毒是典型的动物食品毒性反应。,toxic food reactions 食品毒性反应A c,豆类,豆类：四季豆、红腰豆、白腰豆。,毒素：植物血球凝集素，皂素，蛋白酶抑制剂，脂肪氧化酶，抗维生素因子等,病发时间：进食后,13,小时内,症状：恶心呕吐、腹泻等。,研究发现，煮至,80,未全熟的豆类毒素反而更高，因此必须煮熟煮透煮变色后再吃。,豆类豆类：四季豆、红腰豆、白腰豆。,竹笋,毒素：生氰葡萄糖苷,病发时间：可在数分钟内出现。,症状：喉道收紧、恶心、呕吐、头痛等，严重者甚至死亡。食用时应将竹笋切成薄片，彻底煮熟。,笋含草酸，草酸很容易和钙、锌结合成草酸盐，会影响人体对钙和锌的吸收与利用。,竹笋毒素：生氰葡萄糖苷,果仁和木薯,苹果、杏、梨、樱桃、桃、梅子等水果的种子及果核,毒素：生氰葡萄糖苷（氰苷）,病发时间：可在数分钟内出现。,症状：与竹笋相同。此类水果的果肉都没有毒性，果核或种子却含有毒素，儿童最易受影响，吞下后可能中毒，给他们食用时最好去核。,果仁和木薯苹果、杏、梨、樱桃、桃、梅子等水果的种子及果核,鲜黄花菜（萱草、金针菜）,毒素：秋水仙碱,病发时间：一小时内出现。,症状：肠胃不适、腹痛、呕吐、腹泻等。秋水仙碱可破坏细胞核及细胞分裂的能力，令细胞死亡。经过食品厂加工处理的金针或干金针都无毒，如以新鲜金针入菜，则要彻底煮熟。,鲜黄花菜（萱草、金针菜）毒素：秋水仙碱,发芽马铃薯,青色、发芽、腐烂的马铃薯,毒素：茄碱（龙葵素）,病发时间：一小时内出现。,症状：口腔有灼热感、胃痛、恶心、呕吐。,马铃薯发芽或腐烂时，茄碱含量会大大增加，带苦味，而大部分毒素正存在于青色的部分以及薯皮和薯皮下。茄碱进入体内，会干扰神经细胞之间的传递，并刺激肠胃道黏膜、引发肠胃出血。,发芽马铃薯青色、发芽、腐烂的马铃薯,白果,毒素：银杏酸， 银杏酚,症状：胃肠道症状，恐惧感，头痛，惊叫，抽搐，重者意识丧失。潜伏期,112,小时。,预防：生白果去壳，加水煮熟或炒熟后再吃。熟白果也不能多吃。,白果毒素：银杏酸， 银杏酚,毒蘑菇,有毒成分：毒蝇碱，蜡子树酸，鹿花蕈素，毒肽类等,症状：胃肠炎型，神经精神型，溶血型，脏器损害型,毒蘑菇有毒成分：毒蝇碱，蜡子树酸，鹿花蕈素，毒肽类等,未煮熟豆浆中毒,生豆浆毒素：,皂素；,抗胰蛋白酶因子；,植物血球凝集素等；,预防措施：,文火维持煮沸,5,分钟；,未煮熟豆浆中毒生豆浆毒素：,SYMPTOMS OF ADVERSE FOOD REACTIONS,食品过敏反应的症状,SYMPTOMS OF ADVERSE FOOD REACT,Food intolerance,食品不耐性,enzymatic,(resulting from an enzymatic defect, e.g., lactase deficiency),“,酶促性的”（因酶缺陷造成，如乳糖酶缺乏症）,pharmacological,(depending on the direct effect of, e.g., vaso-active amines naturally found in foods),“,药理学的”（取决于直接效应，如食品中天然存在的血管活性胺）,“,Undefined,不明确的”,Food intolerance 食品不耐性 enzymat,IgE-Mediated Food Allergy,一、以,IgE-,为媒介的食品敏感症,IgE-Mediated Food Allergy一、以,Characteristic,特征,Clinical manifestations of IgE-mediated food allergy can remain localized at the site of the primary direct contact, i.e.,一直保持在最初的直接接触部位,the mouth,嘴,throat (oral allergy syndrome),咽喉（口腔敏感综合症）,the gastroiniesrinal tract (isolated gastrointestinal food allergy),胃肠道（单独的胃肠道食品敏感症）,Characteristic 特征Clinical man,Skin Respiratory tract GI tract Cardievascular S.,皮肤 呼吸道 胃肠道,心脏血管系统,45% 25% 20% 10%,以,IgE,为媒介的食品敏感综合症分布,Skin Respiratory tract GI,Oral Allergy Syndrome,（一）口腔敏感综合病症,Allergen:,fresh foods( fruits and vegetables),过敏原：,新鲜食品（如水果和蔬菜）,Oral Allergy Syndrome （一）口腔敏感,Symptom,症状：,Itching of the lips, mouth, palate,，,throat,嘴唇、嘴、上腭咽喉等处立即发痒,Hoarseness and/or swelling of the lips, tongue, uvula, and larynx,嗓音嘶哑，嘴唇、舌头、小舌、喉等肿胀,Symptom 症状：,Allergic Reactions After Ingestion of Food,（二）摄入食品后的过敏反应,Symptom,症状：,1,）,The main symptoms of gastrointestinal food allergy are vomiting, nausea, diarrhea, and abdominal pains (colics or cramps).,胃肠道主要症状,:,呕吐、反胃、腹泻以及腹部疼痛（绞痛或痛性痉挛）；,Allergic Reactions After Inges,2) Skin reactions include local or generalized pruritus, flush, urticaria, angioedema. morbilliform exanthema, and flare-up of atopic dermatitis,皮肤反应：局部的或无显著特点的搔痒症、面部潮红、风疹、血管性水肿、麻疹样疹病、突发特异性皮炎；,2) Skin reactions include loca,3) The symptoms of the upper and the lower respiratory tract are rhinitis (sneezing, pruritus of the nose, nasal stuffiness, and nasal obstruction), larynx edema, cough, wheezing, and bronchial asthma.,上呼吸道或稍低些的呼吸道症状：,鼻炎（打喷嚏、鼻搔痒症、鼻子不通气、鼻塞）、喉肿、咳嗽、喘息以及支气管哮喘；,3) The symptoms of the upper a,4) Itching, redness, and watering eyes (conjunctivitis),发痒、充血以及眼睛流泪（结膜炎）,.,4) Itching, redness, and water,Allergic Reactions After Inhalation of Food,（三）吸入食品后的过敏反应,Symptom,症状：,respiratory symptoms,呼吸道综合症,Allergic Reactions After Inhal,Allergen:,flour, n-amylase, green coffee, castor and soy beans, spices. egg white, and crustaceans,过敏原：,面粉、,-,淀粉酶、绿咖啡、海狸香和大豆、调味品、鸡蛋白以及甲壳动物,Allergen: flour, n-amylase, gr,Allergic Reactions Following Skin Contact With Food,（四）皮肤接触食品后的过敏反应,Allergen:,fish, shrimp, flour, and pork,过敏原：,鱼、小虾、面粉和猪肉,Allergic Reactions Following S,Symptom,症状：,Urticarial lesion,风疹,Chronic contact with a food may induce protein contact, dermatitis in food handlers,食品操作工人长期接触某种食品会诱导蛋白接触性皮炎。,Symptom 症状：,Non-lgE-Mediated Immune Reactions,二、不以,IgE,为媒介的免疫反应,Non-lgE-Mediated Immune Reacti,Heiners Syndrome, Allergic Alveolitis, and Hemorrhagic Gastroenteritis in Childhood,（一）儿童,Heiner,综合症、过敏性齿槽炎、出血性肠胃炎,DEFINITION,：,The term Heiners syndrome characterizes a milk-induced syndrome with pulmonary disease in infants.,Heiner,综合症：婴儿因牛奶诱导的肺病,Heiners Syndrome, Allergic Al,Symptom,症状：,chronic or recurrent pulmonary intiltrates,慢性或周期性发生的肺渗透,allergic alveolitis,过敏性齿槽炎,a chronic rhinitis,慢性鼻炎,gastrointestinal blood loss,肠胃失血症,iron deficiency anemia,缺铁性贫血,chronic cough,慢性咳嗽,recurrent fever,周期性发烧,Anorexia,厌食,Vomiting,呕吐,Colic,绞痛,Diarrhea,腹泻,Hemoptysis,咳血,Symptom 症状：,Control,控制措施：,institution of a milk-free diet,饮食中去除牛奶,Control 控制措施：,Gluten-Sensitive Enteropathy (Celiac Disease),（二）谷蛋白敏感性肠病（乳糜泻）,Definition,：,damage to the small intestinal mucosa and symptoms of malabsorption,定义：,小肠黏膜损伤和吸收不良症状,Gluten-Sensitive Enteropathy (,Allergen,过敏原：,Gliadin,麦醇溶蛋白,present in wheat, rye, barley, and oat,广泛存在于小麦、燕麦、大麦和黑麦中,Allergen 过敏原：,The peak incidence of symptoms is in infancy after the introduction of cereals;,婴儿开始添加谷物类食物时最容易发生这类症状，为第一高峰期；,A second peak occurs during the third decade.,第二高峰期发生在三十岁。,The peak incidence of symptoms,Symptom,症状：,abdominal pain,周期性腹部疼痛,loose stools,便溏,anorexia,厌食,short stature,体态短小,delayed puberty,青春期滞缓,nutritional deficiencies,吸收不良,Dental enamel hypoplasia,牙科瓷发育不全,recurrent aphthae,周期性口疮,Symptom 症状：,Control,控制措施：,Patients with celiac disease must avoid gliadins and related proteins permanently,远离麦醇溶蛋白以及相关蛋白质,Control 控制措施：,Dermatitis Herpetiformis,（三）疱疹样皮炎,Definition,定义：,chronic blistering disease,一种慢性起疱疾病,Dermatitis Herpetiformis （三）疱疹,Symptom,症状：,itchy,发痒,sometimes burning,有时有灼伤感,eruption of grouped vesicles on an erythematous ground,在红斑状范围内出现成群泡样出疹,Symptom 症状：,Some DH patients, even without gastrointestinal symptoms, may have villous atrophy similar to that seen in celiac disease,有些,DH,病人甚至在没有出现胃肠道综合症的情况下，也会出现与乳糜泻类似的绒毛状萎缩症，也就是说,DH,与,CD,之间有关连。,The cutaneous manifestations may or may not respond to a gluten-free diet,饮食中排除麦醇溶蛋白可能会、也有可能不会改善皮肤症状。,Some DH patients, even without,Eosinophilic Gastroenteritis,（四）嗜酸性胃肠炎,Definition,定义：,elevated eosinophil counts in blood and tissue eosinophilia with release of eosinophii major basic protein,释放嗜曙红细胞主要基本蛋白质后，血液中嗜曙红细胞和嗜曙红血球增多的间质组织内嗜曙红细胞计数值升高,Eosinophilic Gastroenteritis,Clinical manifestations,临床症状：,vomiting,呕吐,abdominal pain,腹部疼痛,Diarrhea,腹泻,malabsorption,吸收不良,bowel obstruction,肠阻塞,Ascites,腹水,Clinical manifestations 临床症状：,The cause of EG is unknown,起因还不清楚,food hypersensitivity has been suggested,EG,可能由食品超敏性引起,The cause of EG is unknown,Utcerative Colitis,（五）溃疡性结肠炎,Definition,定义：,an inflammatory bowel disease of unknown origin,一种不明起因的炎症性肠病,Utcerative Colitis （五）溃疡性结肠炎D,No adverse food reactions have been shown as causative of UC,还不能证明食品不良反应会造成,UC,No adverse food reactions have,Allergic Vasculitis,（六）,变应性脉管炎,Cause,起因：,foods and food additives,食品及其添加剂,Allergic Vasculitis（六）变应性脉管炎,Symptom,症状：,allergic purpura (widespread hemorrhagic macules and papules, mainly on the lower legs) demonstrated by single challenges,变应性紫癜（分布广泛的出血性斑丘疹，主要出现在腿的下部）,Symptom 症状：,Food Intolerance,三、,食品不耐性,Food Intolerance三、食品不耐性,Lactase Deficiency,乳糖酶缺乏综合征,Definition,定义：,Lack of the enzyme that c,l,eaves milk sugar, lactose,gives rise to adverse reactions when lactose is consumed.,当摄入乳糖时，由于体内缺乏一种能将牛奶糖质,-,乳糖水解的酶，从而产生不良反应,Lactase Deficiency乳糖酶缺乏综合征 De,The only food of which lactose is a natural constituent is milk (3.7 g/100 ml cows milk).,天然含乳糖的唯一食品是牛奶（,3.7g/100ml,牛奶）,The only food of which lactose,Classification,分类：,1,）,congenital lactase deficiency,先天性乳糖酶缺乏综合征,2,）,primary lactase deficiency,初级的乳糖酶缺乏综合征,3,）,secondary lactase deficiency,二级乳糖酶缺乏综合征,Classification 分类：,1,）,congenital lactase deficiency,先天性乳糖酶缺乏综合征,lactase is not present and symptoms wil,l,appear when the patient is breast-fed.,人体内不存在乳糖酶，当进行人乳哺育时会出现综合征,The congen,i,tal form is very rare,这种症状极少见,1） congenital lactase deficien,2,）,primary lactase deficiency,初级的乳糖酶缺乏综合征,seen in most of the worlds population where the production of lactase decreases or disappears from the age of 2 to the teenage years,在,2-10,岁时，乳糖酶分泌下降或消失,2） primary lactase deficiency初,Persistent high lactase activity in adult life occurs among relatively few ethnic groups:,成年人体内乳糖酶活性一直处于高峰的人群：,northern Europeans and their overseas descendants,北欧以及沿海后代,a few African groups of pastoral tradition Bedouins and other Saudi Arabs,一些源于牧人的非洲人、贝都因人和沙特阿拉伯人,certain groups from west India and Pakistan,西印度和巴基斯坦部分人群,Persistent high lactase activ,3,）,secondary lactase deficiency,二级乳糖酶缺乏综合征,a consequence of pathological changes in the gut mucosa, as seen in celiac disease or inflammations.,乳糜泻或炎症引起内脏黏膜病变的结果,When the gut mucosa has regained its normal appearance the lactase production reappears,当内脏黏膜恢复正常，乳糖酶也开始重新分泌。,3） secondary lactase deficienc,The symptoms,症状：,Diarrhea,腹泻,gas production,产气,Colic,绞痛,The symptoms 症状：,Control,控制措施：,avoid all products containing even small amounts of lactose,避免食用任何含乳糖的食品,Control 控制措施：,PREVALENCE,发病率,PREVALENCE发病率,The total prevalence of food allergy/food intolerance is not known.,总发病率未知,Estimates based on data from one country do not necessarily reflect the prevalence of another country,在某个国家统计得到的数据并不能用到另一个国家，因为：,1,）,frequency and duration of breast feeding,母乳喂养的频率和持续时间,2,）,eating habits,饮食习惯,3,）,flora,植物群,The total prevalence of food a,Children,一、儿童,Children一、儿童,Food,（一）食品,allergy to cows milk, egg, and fish predominantly begins before the second year of age,对牛奶、鸡蛋和鱼的过敏性主要发生,2,岁以前,allergy to fruit, legumes, and vegetables predominantly begins after the second year.,对水果、豆类和蔬菜的过敏性主要发生在,2,岁以后,Food（一）食品allergy to cows mil,Table 1 Prevalence of Rhinitis and Oral Itch in Danish School Children,丹麦学龄儿童中鼻炎和口腔发痒的发病率,Age (yr) Rhinitis,(%) Oral itch,（,%),boys/girls boys/girls,5-7 9.0/5.7 0/0.38-10 8.5/7.1 0.8/1.111-13 14.0/8-5 1.9/1.514-16 17.3/13.0 2.9/2.0,Table 1 Prevalence of Rhinitis,Food Additives,（二）食品添加剂,Adverse reactions to food additives are found in 1-2% of school children,1-2%,学龄儿童对食品添加剂有不良反应,The prevalence in younger children is not known.,至今不知小年龄儿童的发病率,Food Additives （二）食品添加剂 Adver,Adults,二、成年人,Adults二、成年人,Food,（一）食品,In European studies the majority of allergic food reactions in adults are caused by fruits. vegetables, and nuts and are related to pollen allergy,在欧洲，大部分成年人食品过敏性反应是由水果、蔬菜和坚果引起的，且与花粉过敏症有关,The prevalence is around 5%,发病率在,5%,左右,Food （一）食品In European studies,probably only 0,5% have symptoms other than oral itch.,大约只有,0.5%,不是口腔发痒症状,The prevalence of allergy to milk, egg, fish. etc. is around 0.2%,，牛奶、鸡蛋、鱼等引起的过敏症发病率大约为,0.2%,probably only 0,5% have sympto,Food Additives,（二）食品添加剂,The estimated frequency was 0.03,-,0.15%,1982,年,EEC,理论计算值：食品添加剂引起的发病率为,0.03-0.15%,Food Additives （二）食品添加剂 The e,In British,：,the,prevalence,大不列颠人,：,发病率为,0.026%,Dutch,丹麦,：,0.4%,In British ：theprevalence,Contact Allergens,（三）接触性过敏原,10 % Danish women have contact allergy caused by nickel.,10%,丹麦,妇女因镍造成接触性过敏症,Up to 10% of these may benefit from a nickel-restricted diet,其中,10%,以上会因排除镍的饮食而改善,Contact Allergens （三）接触性过敏原 1,What is contact allergens,？,In dermally sensitized subjects ingestion of the contact allergen may cause skin flare reactions or other symptoms, e.g., in the gastroinlestinal tract,皮肤敏感症受检者摄入接触性过敏原后会导致皮肤潮间带反应或胃肠道症状等其他症状。,What is contact allergens？,Contact Allergens,：,fragrances,芳香物质,food flavors,（,natural or synthetic,）食品风味物,Nickel,镍,Contact Allergens：,Other Adverse Reactions,（四）其它不良反应,1,）,Celiac disease,腹部疾病：,Cause,：,wheat gliadin and related proteins,起因：小麦麦醇溶蛋白和相关蛋白质,The prevalence,：,0.2-0.5%,发病率：,0.2-0.5%,Other Adverse Reactions （四）其它不,2,）,lactase deficiency,乳糖酶缺乏综合征,Cause,：,Lack of lactase,起因：缺乏乳糖酶,The prevalence,：,varies from a few percent in northern European countries to almost the entire adult population in Asia and Africa,发病率：,从北欧国家到亚洲和非洲国家，成年人发病率相差好几个百分点,2） lactase deficiency 乳糖酶缺乏综合征,Conclusion,：,It is not known whether the prevalence of food allergy or intolerance is increasing,不清楚食品过敏,/,不耐性的发病率是否有上升趋势,The prevalence of pollen-related food allergies has increased.,与花粉相关食品敏感症的发病率在提高。,Conclusion：,FOOD ALLERGENS,食品过敏原,FOOD ALLERGENS食品过敏原,Definition,定义,Allergens are antigens that give rise to allergy .,过敏原是能引起敏感的抗原,Definition 定义Allergens are an,Where is food allergens from,？,Pollen,花粉,Mammals,哺乳动物,mites,螨,other insects,其他昆虫,foods,食品,Where is food allergens from？,Component,：过敏原成分：,Proteins or glycoproteins with a molecular weight from 3 to 90 kDa, the majority ranging from 10 to 40 kDa,已知结构的过敏原都是蛋白质或糖蛋白，分子量从,3kDa,到,90kDa,，大部分在,10kDa,到,40kDa,之间,Component：过敏原成分：,The identified allergens,：,the first three letters of the genus, space, the first letter of the species, space, and an Arabic number.,XXX X X,属 种 阿拉伯数字,For example,：,Lol p 1 refers to the first pollen allergen identified from,Lolium perennc, or rye grass,Lol p 1,表示第一个花粉过敏原，来自,Lolium perenne,或黑麦草,The identified allergens：the f,Classification,分类,major,：,proteins for which 50% or more of the allergic patients studied have specific IgE,“,主要的,”,：能使,50%,或以上被研究病人具有特异性,IgE,的蛋白质,minor,“,：,the remaining allergens are considered minor,“,次要的,”,：能使,50%,以下的被研究病人具有特异性,IgE,的蛋白质,Classification 分类major： pro,The,Nature,of Food Allergens,一、过敏原的种类,The Nature of Food Allergens,To make a complete list of allergenic foods on a global basis is virtually impossible.,我们不可能列出一张食品过敏原清单,Whether a food allergen causes significant problems in a population is dependent on several factors,：,某种食品过敏原是否会在消费者中引起明显的问题取决于以下几个方面：,To make a complete list of all,（,a,）,the potency of the allergen,过敏原的效能,some are much more frequent sensitizers lhan others,有些抗体比其他抗体造成敏感症的次数更多，,e.g., -lactoglobulin in milk or ovomucoid from egg white,如：牛奶中的,-,乳球蛋白或鸡蛋蛋白中的卵类粘蛋白,（a）the potency of the allergen,（,b,）,the physiochemical properties,物化性质：,1,）,The chemical structure, i.e., the amino acid sequence, and the tertiary structure,化学结构如氨基酸序列，蛋白质三级结构,2,）,heat stability,热稳定性,3,）,digestibility,可消化性,4,）,Structural relationship with epitopes from nonfood allergens,非食品过敏原与抗原决定族之间的结构关系,（b）the physiochemical properti,（,c,）,the frequency of exposure,暴露的频率：,In Europe allergy to rice and buckwheat is uncommon.,在欧洲，稻米和荞麦一般不引起敏感症,In Japan rice and buckwheat are common food allergens,在日本，稻米和荞麦通常是食品过敏原。,（c） the frequency of exposure,(d) the route of exposure,暴露途径,1,）,aero-allergens,：,grasses, pollen of trees and herbs,，,house dust mites,，,o cat dander,飞散过敏原：,草、树或药草的花粉、屋尘螨、猫毛发皮屑,2,）,work environment,：,baker,工作环境：面包工人,3,）,via the skin,：,Natural rubber (latex),通过皮肤：天然橡胶,(d) the route of exposure 暴露途,（,e,）,cross-reactions to aero-allergens,飞散过敏原的交叉反应,1) local species of grass, trees, and herbs and pollution,当地生长的草、树以及药草种类,e.g., Allergy to hazelnuts is common in areas with many birch trees, where birch pollen hay lever is frequent,榛实敏感症一般发生在有许多桦树的地区，在这些地区经常发生桦树花粉热,2) air pollution,空气污染,（e） cross-reactions to aero-al,(f) the age at which the allergen is introduced,受过敏原入侵的个体年龄,In early infancy an increased uptake of antigen takes place at a time when the gut-associated lymphoid tissue is still incompletely developed,在幼年早期，在与消化道相关淋巴组织还没有发育好的时候，抗原的摄入量相对较高。,(f) the age at which the alle,Allergens of Animal Origin,二、来源于动物的过敏原,Allergens of Animal Origin二、,Milk,（一）牛奶,1,）,Albumin, -lactoglobulin, and immunoglobulins of milk are the most important allergens in infants,婴儿：清蛋白、,-,乳球蛋白和免疫球蛋白,2,）,In older children -lactoglobulin, caseins, and I-lactalbumin may be more reactive.,大孩子：,-,乳球蛋白、酪蛋白和,-,乳白蛋白,3,）,in adulthood,：,casein to be the most frequent allergen,成人期：酪蛋白,Milk （一）牛奶 1）Albumin, -lacto,cross-reactions,交叉反应,The majority of patients with allergy to cows milk proteins will also react to proteins from sheeps and goats milk,大部分对牛奶蛋白质有敏感症的病人同样对绵羊奶和山羊奶有敏感症,Cross-reactions between milk from these species is not always present.,各种奶之间的交叉反应并不一直存在,cross-reactions交叉反应,Eggs,（二）鸡蛋,the second most frequent food allergen in small children after cows milk,在小孩子中大概是仅次于牛奶的食品过敏原,Egg white proteins are reported to elicit allergic reactions more frequently than egg yolk.,鸡蛋蛋白比蛋黄更易引起过敏反应,Eggs（二）鸡蛋 the second most fre,蛋黄中的主要过敏原,蛋黄中的主要过敏原,cross-reactions,交叉反应,:,allergy to egg can be correlated to allergy to bird feathers,鸡蛋敏感症与鸟类羽毛敏感症之间有相关性,the major cross-reacting determinants are the livetins from egg yolk.,主要交叉反应的决定因素是蛋黄中的卵黄蛋白,cross-reactions交叉反应:,Allergens of Plant Origin,三、来源于植物的过敏原,Allergens of Plant Origin三、来,The vegetable foods that most commonly cause hypersensitivity symptoms,致敏性蔬菜种类,hazelnut,榛实,Walnut,胡桃,Brazil nut,巴西坚果,Apple,苹果,Almond,杏仁,Peach,桃子,Plum,李子,Cherry,樱桃,Peanut,花生,Peas,豌豆,Carrot,胡萝卜,parsley,欧芹,Celery,芹菜,Orange,橘子,Strawberry,草莓,Cereals,谷物,The vegetable foods that most,The ranking lists vary depending on,各种蔬菜致敏程度的影响因素,1,）,the age of the patients,病人的年龄,2,）,the methods of diagnosis,诊断方法以及,3,）,the geographic location of the population,地理环境,The ranking lists vary dependi,Fruits,Nuts, and Vegetables,（一）水果、坚果和蔬菜,More than 90% of patients with sensitization to vegetable foods had concomitant sensitization to pollen 90%,以上,的蔬菜敏感症总是伴随着花粉敏感症而来,Fruits, Nuts, and Vegetables,In a group of birch pollen allergies the patients with additional hypersensitivity to nuts and apples had,：,在一组同时有另外的坚果和苹果超敏性的桦树花粉敏感症病人中,(1) more severe symptoms during the pollen season,在花粉季节症状严重加重,(2) higher values of IgE to birch and hazel pollen,桦树和榛子花粉的,IgE,值较高,(3) a larger area of the skin prick test reactive to birch and hazel pollen compared to the group without apple and nut allergy,与那些没有坚果和苹果超敏性病人相比，桦树和榛子花粉的皮肤穿刺试验反应区域要大得多。,In a group of birch pollen all,The symptoms,主要症状：,Mainly from the mouth and pharynx, with itching, swelling of the lips, tongue, and throat. syndrome.,从嘴到咽发痒，嘴唇、舌头以及咽喉肿胀,These symptoms are called the,“,oral allergy,”,“,口腔敏感综合症,”,The symptoms 主要症状：,cross-reactions,交叉反应,:,1,）,A sensitization to mugwort pollens and different spices, the so-called mugwort-celery-spices syndrome, has been reported,艾蒿及其不同种艾属植物的花粉有致敏性，又称艾蒿,-,芹菜,-,香料综合症。,cross-reactions交叉反应:,2,）,It was shown by prick, RAST studies, and RAST inhibition experiments,皮肤穿刺、,RSAT,研究以及,RSAT,抑制实验证明：,a celery-thermolabile allergen seems to be involved in celery-birch-pollen-allergic patients,一种不耐热芹菜过敏原会导致芹菜,-,桦树,-,花粉敏感症,a thermostable allergen is involved in celery -mug wort-allergic patients.,一种耐热过敏原会导致芹菜,-,艾蒿敏感症,2） It was shown by prick, RAST,Pollen-related food allergies are thought to be caused by cross-reactions of pollen-specific IgE antibodies with epitopes of food proteins.,花粉特异,IgE,抗体与食品蛋白质的抗原决定族发生交叉反应，导致了花粉相关食品敏感症,Pollen-related food allergies,Three distinct cross-reactive structures in pollen and vegetable foods,花粉和蔬菜中的,3,个明显交叉反应结构,1,）,Bet v l is the major birch pollen allergen,Bet v 1,是主要的桦树花粉过敏原,Allergens with cross-reactivity to Bet v 1,：,与,Bet v 1,有交叉反应的过敏原有：,Apples,苹果,Hazelnuts,榛实,cherries,樱桃,Pears,梨子,Celery,艾蒿,carrots,胡萝卜,Three distinct cross-reactive,2,）,Profilins are widely distributed in the plant kingdom and have been identified as plant pan Allergens.,Profilin,广泛分布在植物王国，被称为,“,植物,pan,过敏原,”,10 to 20% of the pollen-allergic patients are sensitized to pronlins.,10-20%,花粉敏感病人对,profilins,敏感,2）Profilins are widely distrib,3,）,Cross-reactions of allergen-specific IgE antibodies can be caused by so-called cross-reactive carbohydrate determinants of food and