Food allergy has become an important food quality and safety issue,posing a challenge to the food industry and affecting consumer health.On the one hand,from the perspective of food processing industry,the diversity o...Food allergy has become an important food quality and safety issue,posing a challenge to the food industry and affecting consumer health.On the one hand,from the perspective of food processing industry,the diversity of food raw material ingredients,exogenous additives,and processing forms make the presence of allergens in modern food processing more complex.In addition,due to the lack of allergen identification,effective detection and allergenicity evaluation systems,there are serious deficiencies in the current theories and techniques for food allergen screening and detection,tracking and prediction,intervention and control;On the other hand,from the perspective of public health,meeting consumers'right to know whether there are raw materials containing food allergens in processed foods,and improving the credibility of government and people's satisfaction have become urgent matters;In addition,as people come into contact with more and more new borne novel foods,the probability of food allergy is also increasing.The food safety and health problems induced by increasingly complex,widespread and severe food allergy are difficult to avoid.In view of this,in response to the increasingly serious food allergy issues,this paper introduced the detection methods of food allergens,summarized the reduction and control techniques of food allergens,and elaborated hypoallergenic foods,which aims to provide the basis for preventing and controlling food allergy and ensuring the physical health of food allergy patients.展开更多
In patients with respiratory allergy,cross-reactivity between aeroallergens and foods may induce food allergy,symptoms ranging from oral allergy syndrome to severe anaphylaxis.Clinical entities due to Ig E sensitizati...In patients with respiratory allergy,cross-reactivity between aeroallergens and foods may induce food allergy,symptoms ranging from oral allergy syndrome to severe anaphylaxis.Clinical entities due to Ig E sensitization to cross-reactive aeroallergen and food allergen components are described for many sources of plant origin(pollen-food syndromes and associations,such as birch-apple,cypress-peach and celery-mugwortspice syndromes,and mugwort-peach,mugwortchamomile,mugwort-mustard,ragweed-melon-banana,goosefoot-melon associations),fungal origin(Alternariaspinach syndrome),and invertebrate,mammalian or avian origin(mite-shrimp,cat-pork,and bird-egg syndromes).Clinical cases of allergic reactions to ingestion of food products containing pollen grains of specific plants,in patients with respiratory allergy to Asteraceae pollen,especially mugwort and ragweed,are also mentioned,for honey,royal jelly and bee polen dietary supplements,along with allergic reactions to foods contaminated with mites or fungi in patients with respiratory allergy to these aeroallergens.Medical history and diagnosis approach may be guided by the knowledge about the diverse cross-reacting allergens involved,and by the understanding of these clinical entities which may vary significantly or may be overlapping.The association between primary Ig E sensitization with respiratory symptoms to inhaled allergens and food allergy due to cross-reactive allergen components is important to assess in allergy practice.The use of molecular-based diagnosis improves the understanding of clinically relevant Ig E sensitization to cross-reactive allergen components from aeroallergen sources and foods.展开更多
Food allergens are mainly naturally-occurring proteins with immunoglobulin E(IgE)-binding epitopes.Understanding the structural and immunogenic characteristics of allergenic proteins is essential in assessing whether ...Food allergens are mainly naturally-occurring proteins with immunoglobulin E(IgE)-binding epitopes.Understanding the structural and immunogenic characteristics of allergenic proteins is essential in assessing whether and how food processing techniques reduce allergenicity.We here discuss the impacts of food processing technologies on the modification of physicochemical,structural,and immunogenic properties of allergenic proteins.Detection techniques for characterizing changes in these properties of food allergens are summarized.Food processing helps to reduce allergenicity by aggregating or denaturing proteins,which masks,modifies,or destroys antigenic epitopes,whereas,it cannot eliminate allergenicity completely,and sometimes even improves allergenicity by exposing new epitopes.Moreover,most food processing techniques have been tested on purified food allergens rather than food products due to potential interference of other food components.We provide guidance for further development of processing operations that can decrease the allergenicity of allergenic food proteins without negatively impacting the nutritional profile.展开更多
AIM: To develop a Brown Norway (BN) rat model to determine the potential allergenicity of novel proteins in genetically modified food.METHODS: The allergenicity of different proteins were compared, including ovalbumin...AIM: To develop a Brown Norway (BN) rat model to determine the potential allergenicity of novel proteins in genetically modified food.METHODS: The allergenicity of different proteins were compared, including ovalbumin (OVA), a potent respiratory and food allergen, bovine serum albumin (BSA), a protein that is considered to have a lesser allergenic potential,and potato acid phosphatase (PAP), a non-allergenic protein when administered to BN rats via different routes of exposure (intraperitoneally or by gavage). IgG and IgE antibody responses were determined by ELISA and PCA,respectively. An immunoassay kit was used to determine the plasma histamine level. In addition, possible systemic effect of allergens was investigated by monitoring blood pressure.RESULTS: OVA provoked very vigorous protein-specific IgG and IgE responses, low grade protein-specific IgG and IgE responses were elicited by BSA, while by neither route did PAP elicit anything. In either routes of exposure,plasma histamine level in BN rats sensitized with OVA was higher than that of BSA or PAP. In addition, an oral challenge with BSA and PAP did not induce any effect on blood pressure, while a temporary drop in systolic blood pressure in few animals of each routes of exposure was found by an oral challenge with OVA.CONCLUSION: BN rat model might be a useful and predictive animal model to study the potential allergenicity of novel food proteins.展开更多
Background: Wheat is a potent allergen source and is one of the causes of baker’s asthma and food allergy. The best strategy for managing food hypersensitivity involves strict avoidance of the trigger. However, wheat...Background: Wheat is a potent allergen source and is one of the causes of baker’s asthma and food allergy. The best strategy for managing food hypersensitivity involves strict avoidance of the trigger. However, wheat is quite difficult to avoid. Several alternative strategies for the treatment of food allergy are under study. Spelt is a possible hypoallergenic crop that may be tried in patients with wheat allergy. Methods: We have evaluated the allergenic IgE hypersensitivity mediated by spelt in wheat allergic patients. Overall, 66 patients who suffered from baker’s asthma or food allergy (45 males and 21 females, mean age 28.6 ± 12.9 years) were included. We have also compared its reactivity with standard- ized extracts from wheat and with purified non-specific lipid transfer proteins from wheat (Tri a 14) and from peach (Pru p 3). Immunodetection with spelt and common bread wheat extracts (Triticum aestivum, cultivar Astral) was per- formed. Fresh wheat and spelt grain extracts were used both for oral and bronchial challenge and skin tests. Specific IgE detection to different cereals was performed using the Immuno CAP System (Phadia, Uppsala, Sweden). The bronchial challenge was positive with wheat Astral in 44 (67%) patients, all of them suffered from asthma. Thirteen (29.54%) of these 44 patients had negative the challenge with spelt. The oral challenge with wheat Astral was positive in 22 (33%) patients with wheat food allergy, and the same test was positive in only in 6 of them with spelt (27.3%). The diagnostic yield (sensitivity, specificity and predictive values) of routine tests in determining spelt allergy by specific positive challenge responses was determined. Prick tests for spelt versus positive challenge tests had a good sensitivity (94%, 86.5 - 99.4;95%CI) and specificity (86%, 84 - 90;95% CI) for the diagnosis of spelt allergy. Immunodetection detected minor differences among different extracts. Conclusion: In summary, the prick test and bronchial and oral challenges both efficiently detected sensitization to spelt and their levels were related to more severe clinical profiles, but the wheal area was significantly lower with spelt (p 0.001) and the percentage of positive challenge tests decreased. Our results suggest that spelt is an old crop that may be tried in patients with wheat allergy.展开更多
Objective To analyze the allergic status to common inhalant allergens and food allergens in clinical patients in Harbin in northeastern China and provide evidence to develop the prevention strategy of allergic disease...Objective To analyze the allergic status to common inhalant allergens and food allergens in clinical patients in Harbin in northeastern China and provide evidence to develop the prevention strategy of allergic disease. Methods The data were collected from 5 473 patients with clinical suspected allergic diseases seeking medical care in the Second Affiliated Hospital of Harbin Medical University. Among these patients, 2 530 (46.2%) were males aged 0-86 years, the youngest was only 1 month old and 2 579 (47.1%) were young children and teenagers. The serum specific Immunoglobulin E (slgE) to 14 kinds of common allergens and serum total IgE were detected by using AllergyScreen test (Mediwiss Analytic GmbH, Moers, Germany). Results In 5 473 subjects the positive rate of slgE was 33.1% (n=1 813). Cow milk (6.9%) and wheat (3.1%) were the most common food allergens, followed by house dust mite mix (12.5%) and mould mix (9.4%) and the age and gender specific differences in the positive rate were significant. For the children aged 〈7 years the positive rates to cow milk, beef-mutton, and egg white/egg yolk were high, but the positive rates to house dust mite mix, ragweed estragon, and mould mix were low (P〈0.05). For the adults the positive rates to aeroallergens were high while the rates to food allergens were low. Conclusion The results from this study showed that the food allergens in Harbin had geographic characteristics, which support the viewpoint that the environment factors play an important role in the incidence of allergic diseases. Also, the detection of slgE and total IgE are essential to identify relevant allergens for the purpose of early diagnosis, management and prevention of allergic disease.展开更多
Objective To characterize the relationship between the refolding process of recombinant bovine β-1actoglobulin and its immunoreactivity for clinical purposes. To establish a spectral method which examine the extent o...Objective To characterize the relationship between the refolding process of recombinant bovine β-1actoglobulin and its immunoreactivity for clinical purposes. To establish a spectral method which examine the extent of recombinant allergen renaturation. Methods The refolding process of recombinant bovine β-1actoglobulin was investigated by using circular dichroism, fluorescence and synchronous fluorescence spectra. IgE-binding capacity of recombinant protein was analyzed by ELISA. In addition, bioinformatic methods were used to explain the spectral characteristics and analyze the relationship between the conformational changes and the immunoreactivity of the protein during renaturation in vitro. Results Renaturation of recombinant bovine β-1actoglobulin resulted in a more compact structure resembling the natural counterpart with stronger IgE-binding capacity. Conclusion The degree of protein renaturation Results from this study may be of help for food future. correlated with the IgE-binding capacity of the protein. allergy therapy and development of vaccination in the展开更多
This paper reviews the quality changes that occur towards the food products during the frozen storage period.This research aims to determine the significant physical and chemical changes that had occurred onto the fro...This paper reviews the quality changes that occur towards the food products during the frozen storage period.This research aims to determine the significant physical and chemical changes that had occurred onto the frozen foods.Indeed,refrigerated storage is the easiest way to preserve food within short handling time.Based on the observation,it was discovered that the kinetics reactions help to establish computer-aided quality,prediction models.In certain food products,the negative impact of temperature indicated the need for a thorough evaluation of the quality parameters of individual’s kinetics reaction.In general,a reasonable temperature to store food is-18°C for most frozen foods,and this will retain the quality of commercial storage.展开更多
目的我国苹果过敏的致敏情况研究非常缺乏。本研究拟分析苹果过敏原的组分蛋白的致敏情况,并对苹果过敏的护理干预效果进行研究。方法40例可疑苹果过敏受试者纳入研究,分为苹果耐受组(n=19)和过敏组(n=21)。所有受试者均接受ImmunoCAP...目的我国苹果过敏的致敏情况研究非常缺乏。本研究拟分析苹果过敏原的组分蛋白的致敏情况,并对苹果过敏的护理干预效果进行研究。方法40例可疑苹果过敏受试者纳入研究,分为苹果耐受组(n=19)和过敏组(n=21)。所有受试者均接受ImmunoCAP过敏原sIgE检测,评估苹果及其主要致敏蛋白组分(Mal d 1和Mal d 3),以及Bet v 2的sIgE水平。分析不同组分在苹果过敏组和耐受组的差异,并对苹果过敏组进行护理干预。结果苹果sIgE阳性率为70%,Mal d 1的阳性率为85%,Mal d 3为20%,Bet v 2的阳性率为35.0%。97.5%的患者至少1种苹果过敏原组分阳性。60%的患者仅对1种苹果过敏原组分过敏,35%对2种组分过敏,2.5%的患者对所有3种组分均过敏。其中50%对Mal d 1单一过敏,而10%对Bet v 2单一过敏。Mal d 3与苹果过敏原sIgE呈正相关(r=0.944,P<0.001)。与耐受组相比,苹果过敏组中Mal d 1的sIgE水平显著升高(P<0.001),Bet v 2 sIgE水平显著降低(P=0.036)。ROC分析显示,Mal d 1 sIgE水平在诊断苹果过敏时的曲线下面积(AUC)为0.902,95%CI 0.789~1.000,P<0.001,cut-off值为1.61kUA/L(灵敏度为93.8%,特异性为75.0%)。对苹果过敏组21例患者进行充分护理教育后,患者病情知晓率达100%,必要忌口联合对症治疗后症状控制率达到90.4%(19/21),目前所有患者在长期随访中。结论Mal d 1是苹果过敏的主要组分,是诊断苹果过敏的最佳指标,苹果、Mal d 3和Bet v 2的sIgE对诊断苹果过敏的价值并不显著。对苹果过敏患者进行有效的护理干预可以提高治疗效果。展开更多
基金The authors appreciated the financial support from National Natural Science Foundation of China(32102091)Shandong Provincial Natural Science Foundation(ZR2021QC086)+3 种基金China Postdoctoral Science Foundation(2021M693026)Postdoctoral Innovation Project of Shandong Province(862105033022)Qingdao Postdoctoral Applied Research Project(862105040045)Research Funding of Ocean University of China(862001013187).
文摘Food allergy has become an important food quality and safety issue,posing a challenge to the food industry and affecting consumer health.On the one hand,from the perspective of food processing industry,the diversity of food raw material ingredients,exogenous additives,and processing forms make the presence of allergens in modern food processing more complex.In addition,due to the lack of allergen identification,effective detection and allergenicity evaluation systems,there are serious deficiencies in the current theories and techniques for food allergen screening and detection,tracking and prediction,intervention and control;On the other hand,from the perspective of public health,meeting consumers'right to know whether there are raw materials containing food allergens in processed foods,and improving the credibility of government and people's satisfaction have become urgent matters;In addition,as people come into contact with more and more new borne novel foods,the probability of food allergy is also increasing.The food safety and health problems induced by increasingly complex,widespread and severe food allergy are difficult to avoid.In view of this,in response to the increasingly serious food allergy issues,this paper introduced the detection methods of food allergens,summarized the reduction and control techniques of food allergens,and elaborated hypoallergenic foods,which aims to provide the basis for preventing and controlling food allergy and ensuring the physical health of food allergy patients.
文摘In patients with respiratory allergy,cross-reactivity between aeroallergens and foods may induce food allergy,symptoms ranging from oral allergy syndrome to severe anaphylaxis.Clinical entities due to Ig E sensitization to cross-reactive aeroallergen and food allergen components are described for many sources of plant origin(pollen-food syndromes and associations,such as birch-apple,cypress-peach and celery-mugwortspice syndromes,and mugwort-peach,mugwortchamomile,mugwort-mustard,ragweed-melon-banana,goosefoot-melon associations),fungal origin(Alternariaspinach syndrome),and invertebrate,mammalian or avian origin(mite-shrimp,cat-pork,and bird-egg syndromes).Clinical cases of allergic reactions to ingestion of food products containing pollen grains of specific plants,in patients with respiratory allergy to Asteraceae pollen,especially mugwort and ragweed,are also mentioned,for honey,royal jelly and bee polen dietary supplements,along with allergic reactions to foods contaminated with mites or fungi in patients with respiratory allergy to these aeroallergens.Medical history and diagnosis approach may be guided by the knowledge about the diverse cross-reacting allergens involved,and by the understanding of these clinical entities which may vary significantly or may be overlapping.The association between primary Ig E sensitization with respiratory symptoms to inhaled allergens and food allergy due to cross-reactive allergen components is important to assess in allergy practice.The use of molecular-based diagnosis improves the understanding of clinically relevant Ig E sensitization to cross-reactive allergen components from aeroallergen sources and foods.
基金supported by the National Natural Science Foundation of China (32102605)the Agricultural Science and Technology Innovation Program under Grant (CAAS-ASTIP-2020IAR)the Earmarked Fund for CARS (CARS-44)。
文摘Food allergens are mainly naturally-occurring proteins with immunoglobulin E(IgE)-binding epitopes.Understanding the structural and immunogenic characteristics of allergenic proteins is essential in assessing whether and how food processing techniques reduce allergenicity.We here discuss the impacts of food processing technologies on the modification of physicochemical,structural,and immunogenic properties of allergenic proteins.Detection techniques for characterizing changes in these properties of food allergens are summarized.Food processing helps to reduce allergenicity by aggregating or denaturing proteins,which masks,modifies,or destroys antigenic epitopes,whereas,it cannot eliminate allergenicity completely,and sometimes even improves allergenicity by exposing new epitopes.Moreover,most food processing techniques have been tested on purified food allergens rather than food products due to potential interference of other food components.We provide guidance for further development of processing operations that can decrease the allergenicity of allergenic food proteins without negatively impacting the nutritional profile.
基金Supported by the State 863 Projects, No. 2001AA212291 and 2002AA212041 and the State 973 Project, No. 001CB109007
文摘AIM: To develop a Brown Norway (BN) rat model to determine the potential allergenicity of novel proteins in genetically modified food.METHODS: The allergenicity of different proteins were compared, including ovalbumin (OVA), a potent respiratory and food allergen, bovine serum albumin (BSA), a protein that is considered to have a lesser allergenic potential,and potato acid phosphatase (PAP), a non-allergenic protein when administered to BN rats via different routes of exposure (intraperitoneally or by gavage). IgG and IgE antibody responses were determined by ELISA and PCA,respectively. An immunoassay kit was used to determine the plasma histamine level. In addition, possible systemic effect of allergens was investigated by monitoring blood pressure.RESULTS: OVA provoked very vigorous protein-specific IgG and IgE responses, low grade protein-specific IgG and IgE responses were elicited by BSA, while by neither route did PAP elicit anything. In either routes of exposure,plasma histamine level in BN rats sensitized with OVA was higher than that of BSA or PAP. In addition, an oral challenge with BSA and PAP did not induce any effect on blood pressure, while a temporary drop in systolic blood pressure in few animals of each routes of exposure was found by an oral challenge with OVA.CONCLUSION: BN rat model might be a useful and predictive animal model to study the potential allergenicity of novel food proteins.
文摘Background: Wheat is a potent allergen source and is one of the causes of baker’s asthma and food allergy. The best strategy for managing food hypersensitivity involves strict avoidance of the trigger. However, wheat is quite difficult to avoid. Several alternative strategies for the treatment of food allergy are under study. Spelt is a possible hypoallergenic crop that may be tried in patients with wheat allergy. Methods: We have evaluated the allergenic IgE hypersensitivity mediated by spelt in wheat allergic patients. Overall, 66 patients who suffered from baker’s asthma or food allergy (45 males and 21 females, mean age 28.6 ± 12.9 years) were included. We have also compared its reactivity with standard- ized extracts from wheat and with purified non-specific lipid transfer proteins from wheat (Tri a 14) and from peach (Pru p 3). Immunodetection with spelt and common bread wheat extracts (Triticum aestivum, cultivar Astral) was per- formed. Fresh wheat and spelt grain extracts were used both for oral and bronchial challenge and skin tests. Specific IgE detection to different cereals was performed using the Immuno CAP System (Phadia, Uppsala, Sweden). The bronchial challenge was positive with wheat Astral in 44 (67%) patients, all of them suffered from asthma. Thirteen (29.54%) of these 44 patients had negative the challenge with spelt. The oral challenge with wheat Astral was positive in 22 (33%) patients with wheat food allergy, and the same test was positive in only in 6 of them with spelt (27.3%). The diagnostic yield (sensitivity, specificity and predictive values) of routine tests in determining spelt allergy by specific positive challenge responses was determined. Prick tests for spelt versus positive challenge tests had a good sensitivity (94%, 86.5 - 99.4;95%CI) and specificity (86%, 84 - 90;95% CI) for the diagnosis of spelt allergy. Immunodetection detected minor differences among different extracts. Conclusion: In summary, the prick test and bronchial and oral challenges both efficiently detected sensitization to spelt and their levels were related to more severe clinical profiles, but the wheal area was significantly lower with spelt (p 0.001) and the percentage of positive challenge tests decreased. Our results suggest that spelt is an old crop that may be tried in patients with wheat allergy.
文摘Objective To analyze the allergic status to common inhalant allergens and food allergens in clinical patients in Harbin in northeastern China and provide evidence to develop the prevention strategy of allergic disease. Methods The data were collected from 5 473 patients with clinical suspected allergic diseases seeking medical care in the Second Affiliated Hospital of Harbin Medical University. Among these patients, 2 530 (46.2%) were males aged 0-86 years, the youngest was only 1 month old and 2 579 (47.1%) were young children and teenagers. The serum specific Immunoglobulin E (slgE) to 14 kinds of common allergens and serum total IgE were detected by using AllergyScreen test (Mediwiss Analytic GmbH, Moers, Germany). Results In 5 473 subjects the positive rate of slgE was 33.1% (n=1 813). Cow milk (6.9%) and wheat (3.1%) were the most common food allergens, followed by house dust mite mix (12.5%) and mould mix (9.4%) and the age and gender specific differences in the positive rate were significant. For the children aged 〈7 years the positive rates to cow milk, beef-mutton, and egg white/egg yolk were high, but the positive rates to house dust mite mix, ragweed estragon, and mould mix were low (P〈0.05). For the adults the positive rates to aeroallergens were high while the rates to food allergens were low. Conclusion The results from this study showed that the food allergens in Harbin had geographic characteristics, which support the viewpoint that the environment factors play an important role in the incidence of allergic diseases. Also, the detection of slgE and total IgE are essential to identify relevant allergens for the purpose of early diagnosis, management and prevention of allergic disease.
基金supported by the Natural Science Foundation of China (30871752)the High-tech Industrialization Funding of Guangdong Province (2009B011300010)
文摘Objective To characterize the relationship between the refolding process of recombinant bovine β-1actoglobulin and its immunoreactivity for clinical purposes. To establish a spectral method which examine the extent of recombinant allergen renaturation. Methods The refolding process of recombinant bovine β-1actoglobulin was investigated by using circular dichroism, fluorescence and synchronous fluorescence spectra. IgE-binding capacity of recombinant protein was analyzed by ELISA. In addition, bioinformatic methods were used to explain the spectral characteristics and analyze the relationship between the conformational changes and the immunoreactivity of the protein during renaturation in vitro. Results Renaturation of recombinant bovine β-1actoglobulin resulted in a more compact structure resembling the natural counterpart with stronger IgE-binding capacity. Conclusion The degree of protein renaturation Results from this study may be of help for food future. correlated with the IgE-binding capacity of the protein. allergy therapy and development of vaccination in the
文摘This paper reviews the quality changes that occur towards the food products during the frozen storage period.This research aims to determine the significant physical and chemical changes that had occurred onto the frozen foods.Indeed,refrigerated storage is the easiest way to preserve food within short handling time.Based on the observation,it was discovered that the kinetics reactions help to establish computer-aided quality,prediction models.In certain food products,the negative impact of temperature indicated the need for a thorough evaluation of the quality parameters of individual’s kinetics reaction.In general,a reasonable temperature to store food is-18°C for most frozen foods,and this will retain the quality of commercial storage.
文摘目的我国苹果过敏的致敏情况研究非常缺乏。本研究拟分析苹果过敏原的组分蛋白的致敏情况,并对苹果过敏的护理干预效果进行研究。方法40例可疑苹果过敏受试者纳入研究,分为苹果耐受组(n=19)和过敏组(n=21)。所有受试者均接受ImmunoCAP过敏原sIgE检测,评估苹果及其主要致敏蛋白组分(Mal d 1和Mal d 3),以及Bet v 2的sIgE水平。分析不同组分在苹果过敏组和耐受组的差异,并对苹果过敏组进行护理干预。结果苹果sIgE阳性率为70%,Mal d 1的阳性率为85%,Mal d 3为20%,Bet v 2的阳性率为35.0%。97.5%的患者至少1种苹果过敏原组分阳性。60%的患者仅对1种苹果过敏原组分过敏,35%对2种组分过敏,2.5%的患者对所有3种组分均过敏。其中50%对Mal d 1单一过敏,而10%对Bet v 2单一过敏。Mal d 3与苹果过敏原sIgE呈正相关(r=0.944,P<0.001)。与耐受组相比,苹果过敏组中Mal d 1的sIgE水平显著升高(P<0.001),Bet v 2 sIgE水平显著降低(P=0.036)。ROC分析显示,Mal d 1 sIgE水平在诊断苹果过敏时的曲线下面积(AUC)为0.902,95%CI 0.789~1.000,P<0.001,cut-off值为1.61kUA/L(灵敏度为93.8%,特异性为75.0%)。对苹果过敏组21例患者进行充分护理教育后,患者病情知晓率达100%,必要忌口联合对症治疗后症状控制率达到90.4%(19/21),目前所有患者在长期随访中。结论Mal d 1是苹果过敏的主要组分,是诊断苹果过敏的最佳指标,苹果、Mal d 3和Bet v 2的sIgE对诊断苹果过敏的价值并不显著。对苹果过敏患者进行有效的护理干预可以提高治疗效果。