花椒严重过敏反应及花椒致敏组分分析  

Clinical Features of Pericarpium Zanthoxyli Allergy Analysis and of Its Allergy Component

作　　者：李宏[1] 程璇[1] 尹佳[1] 王瑞琦[1] 张宏誉[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院变态反应科,北京100730

出　　处：《中华临床免疫和变态反应杂志》2009年第3期184-189,共6页Chinese Journal of Allergy & Clinical Immunology

基　　金：国家科技部卫生行业基金中国过敏性疾病流行病学研究及规范化防治项目(200802001)

摘　　要：目的总结15例花椒严重过敏反应患者的临床特点、点刺试验、特异性IgE结果,并对花椒致敏组分进行分析。方法采用统一问卷,收集所有花椒过敏反应患者的临床资料。用ImmunoCAP检测血清花椒籽和花椒皮特异性IgE。用Powerlook2100XL(UMAX)扫描和imageQuant TL软件分析花椒籽和花椒皮的SDS-PAGE蛋白电泳成分和免疫印迹结果。结果花椒过敏15例,男6例、女9例,就诊年龄28～59岁,均表现为速发型食物过敏反应,过敏反应均发生于进食过敏食物后30分钟内;14例诊断为严重过敏反应,其中5例曾发生过敏性休克(2例伴有意识丧失),1例诊断为急性荨麻疹。14例起始症状为口咽部过敏反应。该组病例均伴有多种食物,如腰果、开心果、橘子、金桔、芝麻、杏仁、榛子、松子、芒果等过敏;15例均存在腰果和/或开心果过敏,但进食花生、黄豆均不过敏。食物过敏病程1～17年不等。10例过敏患者花椒籽点刺试验均为强阳性,2例为3+、8例为4+,2例出现全身反应,24小时内好转;花椒皮点刺试验1例为2+,2例为+,7例为-。3例健康对照者花椒皮和花椒籽点刺试验均为阴性。13例花椒过敏患者中,花椒籽特异性IgE,1例为2级,余12例均为3级以上;花椒皮特异性IgE,11例为0级,2例为2级。花椒籽与花椒皮特异性IgE比较,差异有显著性意义(P<0.00014)。花椒籽和花椒皮致敏组分蛋白免疫印记结果显示,7例患者中1例相对分子质量为11400～12400,3例为11400,1例为11300,1例为11400～12500,1例无结合条带。结论进食少量花椒即可能诱发严重的过敏反应,甚至过敏性休克。花椒过敏反应是由IgE介导的速发型食物过敏反应,部分患者可表现为速发相和迟发相双相反应。花椒变应原来自花椒籽,而不是花椒皮。对花椒高度敏感个体,花椒点刺试验有可能诱发全身过敏反应。目前检测到的花椒籽变应原致敏组分蛋白的相对分子质量为11300～12Objective To summary the clinical festures of 15 cases with pericarpium zanthoxyli allergy and investigated its allergy component. Methods The clinical data were collected by unified questionnaires. Skin prick tests of pericarpium zanthoxyli seed and peel were performed separately. Three healthy controls were also prescribed skin prick tests. Specific IgE measurement （Immuno-CAP） for both seed and peel of pericarpium zanthoxyli were detected. SDS-PAGE and Immunoblot were performed. Powerlook 2100XL （UMAX） scanning software and image quant TL were used to analysis the results of immunobot. Results Fifteen patients with pericarpium ＇zanthoxyli allergy, male/female =6/9, age 28-59 yrs, all revealed immediate hypersensitivity. The initial symptom was an oropharygeal symptom in 14 cases, which were developed anaphylaxis later. Among these 14 cases, 5 cases developed allergic shock and 2 of them loss consciousness. Only 1 case was diagnosed as acute urticaria. All cases were suffering from multiple food allergy. The co-allergy foods were cashew-nut, pistachio nut, orange, kumquat, sesame, almond, hazelnut, pine nut mango, ect. All cases were also attached by either cashew nut or pistachio nut, allergy or both. For pericarpium zanthoxyli seed skin prick tests showed strong reaction （8/10 ＋＋＋＋, 2/10 ＋＋＋）, while pericarpium zanthoxyli peel skin prick tests showed weak reaction （1/10 ＋＋, 2/10 ＋, 7/10 -）. 3 healthy controls showed negative results for both seed and peel prick tests. Specific IgE of pericarpium zanthoxyli for 13 cases showed that 12 cases were more than 3 grades and 1 case was 2 grades for the seed; 11 case were 0 grade and 2 cases were 2 grades for the peel. There is statistical significance between the results of the specific IgE of seed and peel. Seven as 11 400-12 400 for 1 case, 11 400 for 3 cases, cases immuno-blot showed protein binding bands 11 300 for 1 case, 11 400-12 500 for 1 case, no binding band for 1 case. Conclusions Pericarpium zanthoxyli allergy is an I

关 键 词：花椒过敏 食物过敏 腰果过敏 

分 类 号：R593[医药卫生—内科学]