【正文】 面粉和豬肉 ?Symptom 癥狀： Urticarial lesion 風(fēng)疹 ? Chronic contact with a food may induce protein contact, dermatitis in food handlers 食品操作工人長期接觸某種食品會誘導(dǎo)蛋白接觸性皮炎 。s Syndrome, Allergic Alveolitis, and Hemorrhagic Gastroenteritis in Childhood （一）兒童 Heiner綜合癥、過敏性齒槽炎、出血性腸胃炎 DEFINITION： The term Heiner39。 嬰兒開始添加谷物類食物時最容易發(fā)生這類癥狀 ， 為第一高峰期； A second peak occurs during the third decade. 第二高峰期發(fā)生在三十歲。 ? The cutaneous manifestations may or may not respond to a glutenfree diet 飲食中排除麥醇溶蛋白可能會 、 也有可能不會改善皮膚癥狀 。s population where the production of lactase decreases or disappears from the age of 2 to the teenage years 在 210歲時，乳糖酶分泌下降或消失 ? Persistent high lactase activity in adult life occurs among relatively few ethnic groups: 成年人體內(nèi)乳糖酶活性一直處于高峰的人群： ? northern Europeans and their overseas descendants北歐以及沿海后代 ? a few African groups of pastoral tradition Bedouins and other Saudi Arabs一些源于牧人的非洲人 、 貝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 ? 3） secondary lactase deficiency二級乳糖酶缺乏綜合征 a consequence of pathological changes in the gut mucosa, as seen in celiac disease or inflammations. 乳糜瀉或炎癥引起內(nèi)臟黏膜病變的結(jié)果 When the gut mucosa has regained its normal appearance the lactase production reappears 當內(nèi)臟黏膜恢復(fù)正常，乳糖酶也開始重新分泌。s milk, egg, and fish predominantly begins before the second year of age 對牛奶 、 雞蛋和魚的過敏性主要發(fā)生 2歲以前 ? allergy to fruit, legumes, and vegetables predominantly begins after the second year. 對水果、豆類和蔬菜的過敏性主要發(fā)生在 2歲以后 ? Table 1 Prevalence of Rhinitis and Oral Itch in Danish School Children 丹麥學(xué)齡兒童中鼻炎和口腔發(fā)癢的發(fā)病率 Age (yr) Rhinitis (%) Oral itch（ %) boys/girls boys/girls 57 810 1113 1416 Food Additives （二）食品添加劑 ? Adverse reactions to food additives are found in 12% of school children 12%學(xué)齡兒童對食品添加劑有不良反應(yīng) ? The prevalence in younger children is not known. 至今不知小年齡兒童的發(fā)病率 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 在歐洲，大部分成年人食品過敏性反應(yīng)是由水果、蔬菜和堅果引起的，且與花粉過敏癥有關(guān) ? The prevalence is around 5% 發(fā)病率在 5%左右 ? probably only 0,5% have symptoms other than oral itch. 大約只有 %不是口腔發(fā)癢癥狀 ? The prevalence of allergy to milk, egg, fish. etc. is around %，牛奶、雞蛋、魚等引起的過敏癥發(fā)病率大約為 % Food Additives （二）食品添加劑 ? The estimated frequency was % 1982年 EEC理論計算值：食品添加劑引起的發(fā)病率為 % ? In British ： the prevalence 大不列顛人 ： 發(fā)病率為 % ? Dutch 丹麥 ： % Contact Allergens （三）接觸性過敏原 ? 10 % Danish women have contact allergy caused by nickel. 10%丹麥 婦女因鎳造成接觸性過敏癥 ? Up to 10% of these may benefit from a nickelrestricted diet 其中 10%以上會因排除鎳的飲食而改善 ?What is contact allergens？ In dermally sensitized subjects ingestion of the contact allergen may cause skin flare reactions or other symptoms, ., in the gastroinlestinal tract 皮膚敏感癥受檢者攝入接觸性過敏原后會導(dǎo)致皮膚潮間帶反應(yīng)或胃腸道癥狀等其他癥狀。 FOOD ALLERGENS 第五節(jié) 食品過敏原 Definition 定義 ? Allergens are antigens that give rise to allergy . 過敏原是能引起敏感的抗原 Where is food allergens from？ ? Pollen花粉 ? Mammals哺乳動物 ? mites螨 ? other insects其他昆蟲 ? foods食品 ?Component：過敏原成分： Proteins or glycoproteins with a molecular weight from 3 to 90 kDa, the majority ranging from 10 to 40 kDa 已知結(jié)構(gòu)的過敏原都是蛋白質(zhì)或糖蛋白，分子量從 3kDa到 90kDa，大部分在 10kDa到40kDa之間 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 屬 種 阿拉伯數(shù)字 ? For example： Lol p 1 refers to the first pollen allergen identified from Lolium perennc, or rye grass Lol p 1表示第一個花粉過敏原，來自 Lolium perenne 或黑麥草 Classification 分類 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異性 IgE的蛋白質(zhì) minor“： the remaining allergens are considered minor “次要的 ” ：能使 50%以下的被研究病人具有特異性 IgE的蛋白質(zhì) The Nature of Food Allergens 一、過敏原的種類 ? To make a plete list of allergenic foods on a global basis is virtually impossible. 我們不可能列出一張食品過敏原清單 ? Whether a food allergen causes significant problems in a population is dependent on several factors： 某種食品過敏原是否會在消費者中引起明顯的問題取決于以下幾個方面： （ a） the potency of the allergen 過敏原的效能 ? some are much more frequent sensitizers lhan others 有些抗體比其他抗體造成敏感癥的次數(shù)更多 ， ., β lactoglobulin in milk or ovomucoid from egg white 如：牛奶中的 β乳球蛋白或雞蛋蛋白中的卵類粘蛋白 （ b） the physiochemical properties 物化性質(zhì)： 1） The chemical structure, ., the amino acid sequence, and the tertiary structure 化學(xué)結(jié)構(gòu)如氨基酸序列 ， 蛋白質(zhì)三級結(jié)構(gòu) 2） heat stability 熱穩(wěn)定性 3） digestibility 可消化性 4） Structural relationship with epitopes from nonfood allergens 非食品過敏原與抗原決定族之間的結(jié)構(gòu)關(guān)系 （ c） the frequency of exposure 暴露的頻率： ? In Europe allergy to rice and buckwheat is unmon. 在歐洲 ， 稻米和蕎麥一般不引起敏感癥 ? In Japan rice and buckwheat are mon food allergens 在日本 ， 稻米和蕎麥通常是食品