五、食品敏感性.ppt

Food Sensitivities, Food Sensitivities, Allergic Reactions, and Allergic Reactions, and Food IntolerancesFood Intolerances 食品敏感性、过敏性反应食品敏感性、过敏性反应 和食品不耐性和食品不耐性 CONTENTS CONTENTS 主要内容主要内容lDEFINITION AND MECHANISMS OF ADVERSE FOOD REACTION 第一节 食品不良反应的定义和机理lSYMPTOMS OF ADVERSE FOOD REACTIONS 第二节 食品不良反应的症状lDIAGNOSIS OF ADVERSE FOOD REACTIONS 第三节 食品不良反应的诊断法lPREVALENCE 第四节 发病率lFOOD ALLERGENS 第五节 食品过敏原lFOOD ADDITIVES 第六节 食品添加剂lFOOD LABELING IN RELATION TO FOOD SENSITIVITIES 第七节 与食品过敏性有关的食品标签DEFINITION AND DEFINITION AND MECHANISMS OF ADVERSE MECHANISMS OF ADVERSE FOOD REACTIONFOOD REACTION 第一节第一节 食品不良反应的定义和食品不良反应的定义和 机理机理Fig.1 Classification of foods proposed by EAACI图1 EAACI对食品的分级toxic food reactionstoxic food reactions 食品毒性反应食品毒性反应lA 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食品毒性反应。

Food intolerance Food intolerance 食品不耐性食品不耐性 lenzymatic (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 ） lpharmacological (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）l“Undefined不明确的”SYMPTOMS OF ADVERSE SYMPTOMS OF ADVERSE FOOD REACTIONSFOOD REACTIONS 第二节第二节 食品不良反应的症状食品不良反应的症状IgE-Mediated Food AllergyIgE-Mediated Food Allergy一、以一、以IgE-IgE-为媒介的食品敏感症为媒介的食品敏感症 Characteristic Characteristic 特征特征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） 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%Figure 2 Classical symptoms of IgE-mediated food ailergy 图2 以IgE为媒介的食品敏感综合症分布Oral Allergy Syndrome Oral Allergy Syndrome （一）口腔敏感综合病症（一）口腔敏感综合病症 lAllergen: fresh foods( fruits and vegetables)过敏原：新鲜食品（如水果和蔬菜）lSymptom 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Allergic Reactions After Allergic Reactions After Ingestion of Food Ingestion of Food （二）摄入食品后的过敏反应（二）摄入食品后的过敏反应 lSymptom 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）；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；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；4) Itching, redness, and watering eyes (conjunctivitis)发痒、充血以及眼睛流泪（结膜炎）.Allergic Reactions After Allergic Reactions After Inhalation of Food Inhalation of Food （三）吸入食品后的过敏反应（三）吸入食品后的过敏反应lSymptom 症状：respiratory symptoms 呼吸道综合症 lAllergen: flour, n-amylase, green coffee, castor and soy beans, spices. egg white, and crustaceans 过敏原：面粉、α-淀粉酶、绿咖啡、海 狸香和大豆、调味品、鸡蛋白以及甲壳 动物 Allergic Reactions Following Skin Allergic Reactions Following Skin Contact With FoodContact With Food （四）皮肤接触食品后的过敏反应（四）皮肤接触食品后的过敏反应 lAllergen: fish, shrimp, flour, and pork 过敏原：鱼、小虾、面粉和猪肉 lSymptom 症状： Urticarial lesion 风疹lChronic 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。

Non-lgE-Mediated Immune Non-lgE-Mediated Immune ReactionsReactions 二、不以二、不以IgEIgE为媒介的免疫反应为媒介的免疫反应 Heiner's Syndrome, Allergic Alveolitis, and Heiner's Syndrome, Allergic Alveolitis, and Hemorrhagic Gastroenteritis in ChildhoodHemorrhagic Gastroenteritis in Childhood （一）儿童（一）儿童HeinerHeiner综合症、过敏性齿槽炎、综合症、过敏性齿槽炎、 出血性肠胃炎出血性肠胃炎DEFINITION：The term Heiner's 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 lSymptom 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lControl 控制措施：linstitution of a milk-free diet饮食中去除牛奶Gluten-Sensitive Enteropathy Gluten-Sensitive Enteropathy (Celiac Disease)(Celiac Disease) （二）谷蛋白敏感性肠病（乳糜泻）（二）谷蛋白敏感性肠病（乳糜泻）lDefinition：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小肠 黏膜损伤和吸收不良症状 lAllergen 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 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。

lSymptom 症状：labdominal pain周期性腹部疼痛lloose stools便溏lanorexia厌食lshort s。