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首页> 外文期刊>World Journal of Gastroenterology >Colorectal mucosal histamine release by mucosa oxygenation in comparison with other established clinical tests in patients with gastrointestinally mediated allergy.
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Colorectal mucosal histamine release by mucosa oxygenation in comparison with other established clinical tests in patients with gastrointestinally mediated allergy.

机译：与胃肠道介导的变态反应患者的其他已建立的临床试验相比，通过粘膜氧合释放的结肠直肠粘膜组胺。

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AIM: This study evaluated colorectal mucosal histamine release in response to blinded food challenge-positive and -negative food antigens as a new diagnostic procedure. METHODS: 19 patients suffering from gastrointestinally mediated allergy confirmed by blinded oral provocation were investigated on grounds of their case history, skin prick tests, serum IgE detection and colorectal mucosal histamine release by ex vivo mucosa oxygenation. Intact tissue particles were incubated/stimulated in an oxygenated culture with different food antigens for 30 min. Specimens challenged with anti-human immunoglobulin E and without any stimulus served as positive and negative controls, respectively. Mucosal histamine release (% of total biopsy histamine content) was considered successful (positive), when the rate of histamine release from biopsies in response to antigens reached more than twice that of the spontaneous release. Histamine measurement was performed by radioimmunoassay. RESULTS: The median (range) of spontaneous histamine release from colorectal mucosa was found to be 3.2 (0.1%-25.8%) of the total biopsy histamine content. Food antigens tolerated by oral provocation did not elicit mast cell degranulation 3.4 (0.4%-20.7%, P = 0.4), while anti-IgE and causative food allergens induced a significant histamine release of 5.4 (1.1%-25.6%, P = 0.04) and 8.1 (1.5%-57.9%, P = 0.008), respectively. 12 of 19 patients (63.1%) showed positive colorectal mucosal histamine release in accordance with the blinded oral challenge responding to the same antigen (s), while the specificity of the functional histamine release to accurately recognise tolerated foodstuffs was found to be 78.6%. In comparison with the outcome of blinded food challenge tests, sensitivity and specificity of history (30.8% and 57.1%), skin tests (47.4% and 78.6%) or antigen-specific serum IgE determinations (57.9% and 50%) were found to be of lower diagnostic accuracy in gastrointestinally mediated allergy. CONCLUSION: Functional testing of the reactivity of colorectal mucosa upon antigenic stimulation in patients with gastrointestinally mediated allergy is of higher diagnostic efficacy.
机译：目的：本研究评估了盲肠食物激发阳性和阴性食物抗原对大肠黏膜组胺释放的影响，作为一种新的诊断方法。方法：对19例经盲目口服刺激确诊的胃肠道过敏患者进行了病史，皮肤点刺试验，血清IgE检测和离体粘膜充氧释放大肠黏膜组胺的研究。将完整的组织颗粒在含不同食物抗原的含氧培养物中孵育/刺激30分钟。用抗人免疫球蛋白E攻击且没有任何刺激的标本分别作为阳性和阴性对照。当活组织检查中响应抗原的组胺释放速率达到自发释放速率的两倍以上时，认为粘膜组胺释放（占活组织检查总组胺含量的百分比）是成功的（阳性）。组胺的测定通过放射免疫法进行。结果：从结肠直肠粘膜中释放的自发组胺的中位值（范围）为活检组胺总含量的3.2（0.1％-25.8％）。口服刺激所能耐受的食物抗原未引起肥大细胞脱粒3.4（0.4％-20.7％，P = 0.4），而抗IgE和致病性食物致敏原诱导组胺显着释放5.4（1.1％-25.6％，P = 0.04） ）和8.1（1.5％-57.9％，P = 0.008）。 19位患者中有12位（63.1％）响应对相同抗原的盲法口服攻击显示结直肠粘膜组胺阳性释放，而准确识别耐受食品的功能组胺释放的特异性为78.6％。与盲法食物激发试验的结果相比，发现病史的敏感性和特异性（分别为30.8％和57.1％），皮肤试验（分别为47.4％和78.6％）或抗原特异性血清IgE测定（分别为57.9％和50％）在胃肠道介导的变态反应中的诊断准确性较低。结论：在胃肠道介导的过敏患者中，抗原刺激后结直肠黏膜反应性的功能测试具有较高的诊断效力。

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