过敏

过敏
过敏
	荨麻疹是一种常见的过敏症状。
类型	immunoglobulin mediated immune response[*]、超敏反应、疾病
病因	过敏原
分类和外部资源
医学专科	免疫学
ICD-10	T78.4
ICD-9-CM	995.3
DiseasesDB	33481
MedlinePlus	000812
eMedicine	med/1101
MeSH	D006967
	[编辑此条目的维基数据]

过敏（英语：allergy）或变应性^[1]、变态反应^[2]、变应性疾病^[3]（allergic disease），是机体对某些抗原初次应答致敏后，再次接受相同抗原刺激时，所出现的异常过度特异性免疫应答，其表现以生理功能障碍或组织损伤为主^[4]^[5]^[6]。由于医学历史的演进，目前大部分学者认为过敏等同于I型超敏反应^[7]^[8]^[9]。

过敏原因子一般为人体接触环境中对人毒性不大的物质^[10]^[11]，人体对于某些过敏原过度反应的现象，包含过敏性鼻炎、食物过敏、荨麻疹、异位性皮肤炎、哮喘与全身型过敏性反应等^[12]^[13]；症状可能有红眼、引起搔痒的皮疹、流鼻水、呼吸困难与肿胀等^[14]。食物耐受不佳与食物中毒是两种不一样的现象^[15]^[16]。

常见的过敏原有食物和花粉^[17]。金属和其他物质也可能引发过敏^[11]。食物、蚊虫叮咬和药物常造成严重的过敏反应。症状的发展同时取决于遗传和环境^[18]。过敏的原始机制是IgE抗体，会与过敏原结合，并释放组织胺等引起发炎的化学物质^[19]。过敏的确诊通常依据病患的医疗史进行判断。特定病例必须进行皮肤试验或血液检查做进一步判定^[16]。然而，检验结果为阳性，并不代表所检验的过敏原就是引发过敏的单一物质^[20]。蜜蜂、黄蜂、火蚁是主要引起过敏反应的昆虫^[21]。

在幼年时期，暴露在常见的过敏原也许具有保护作用^[22]。美国1997-2011年间对18岁以下儿童进行调查，各年龄组间食物过敏患病率无差异显著。然而，皮肤过敏随着年龄的增加而下降，而呼吸道过敏随着年龄的增加而增加^[23]。过敏的治疗包括：避开已知的过敏原和使用皮质类固醇与抗组织胺药^[24]。严重过敏时，应紧急静脉注射肾上腺素^[25]。所谓的过敏原免疫疗法（英语：Allergen immunotherapy），是一种治疗方法，该治疗方法将病人暴露在逐渐增量的过敏原下，常用在某些特定的过敏疾病，像是干草热或是昆虫叮咬^[26]。过敏原免疫疗法对于食物过敏的效果尚不明^[24]。

过敏是相当常见的症状^[27]。在发达国家，大约20%的人被过敏性鼻炎所困扰^[28]，大约6%的人至少有过一次食物过敏的经验^[16]^[22]，有将近20%的人，一生之中至少经历一次异位性皮肤炎^[29]。依据国家的不同，有 1%到18%的人有气喘的症状^[30]，0.05%到2%的人会经历全身性过敏^[31]。许多过敏性的疾病的比例有上升的趋势^[25]^[32]。1906年，克莱门斯·冯·皮尔奎（英语：Clemens von Pirquet）首次使用“allergy”这个字来命名过敏^[18]。

传统观念上会认为过敏是因为体内抵抗力太低，实际上过敏是一项人体对外界物质的过度反应现象，跟抵抗力低下并无关联。多数过敏反应都是人体对无害物质所产生的排斥现象。会依照个体的不同而对于不同物质产生过敏，也因此并非所有过敏患者，都对同项物质产生过敏现象，所以才会通过过敏原检测的方式，来检视各个过敏患者的过敏物质。

超敏反应

超敏反应（hypersensitivity）分为四型：第一型为即发性超敏反应（immediate），它也叫作IgE介导型超敏反应、第二型为抗体依赖型和细胞毒杀超敏反应（antibody-dependent cytotoxic）、第三型为免疫复合体媒介超敏反应（immune complex-mediated ）、第四型为迟发性超敏反应（delayed-type）。

而过敏（allergy）属于一种超敏反应，一般多为第一型；过敏性接触性皮肤炎则为例外，属于第四型。

过敏性疾病

参看

参考资料

^ 《英汉汉英医学大词典》编委会. 英汉汉英医学大词典. 学苑出版社. 1997: 19. ISBN 9787507711585.
^ 王建东, 王怀立. 《欧洲变态反应与临床免疫学会严重过敏反应指南2021版》解读 [J] . 中国小儿急救医学, 2022, 29(4) : 260-265. DOI: 10.3760/cma.j.issn.1673-4912.2022.04.005.
^ 乔燕.益生菌对变应性疾病作用机制的研究进展[J].临床耳鼻咽喉头颈外科杂志, 2016, 30(18):5.DOI:10.13201/j.issn.1001-1781.2016.18.018.
^ 何韶衡.以过敏性疾病发病机制为基础浅析其辅助诊断手段及临床意义[J].中华临床免疫和变态反应杂志, 2011, 05(001):1-4.DOI:10.3969/j.issn.1673-8705.2011.01.001.
^ 王莲芸.过敏性疾病的发病机理[C]//2017上海市医学会变态反应学术年会.;上海市医学会;;, 2017.
^ 刘红,俞雨生.变态反应性疾病发病机制及其治疗[J].肾脏病与透析肾移植杂志, 2002, 11(2):6.DOI:10.3969/j.issn.1006-298X.2002.02.021.
^ Janeway CA Jr, Travers P, Walport M, et al. Immunobiology: The Immune System in Health and Disease. 5th edition. New York: Garland Science; 2001. Chapter 12, Allergy and Hypersensitivity. Available from: https://www.ncbi.nlm.nih.gov/books/NBK10756/
^ Hypersensitivity (Allergy). In: Levinson W, Chin-Hong P, Joyce EA, Nussbaum J, Schwartz B. eds. Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 16e. McGraw Hill; 2020. Accessed September 03, 2024. https://accessmedicine.mhmedical.com/content.aspx?bookid=2867&sectionid=242768630
^ Hasan-Abad, A.M., Mohammadi, M., Mirzaei, H. et al. Impact of oligomerization on the allergenicity of allergens. Clin Mol Allergy 20, 5 (2022). https://doi.org/10.1186/s12948-022-00172-1
^ 過敏反應—對無害物質產生的免疫反應. 长庚生物科技. [2014-08-07]. （原始内容存档于2019-08-23）.
^ ^11.0 ^11.1 McConnell, Thomas H. The nature of disease : pathology for the health professions. Baltimore, Mar.: Lippincott Williams & Wilkins. 2007: 159 [2015-07-13]. ISBN 9780781753173. （原始内容存档于2020-12-22）.
^ Types of Allergic Diseases. NIAID. May 29, 2015 [17 June 2015]. （原始内容存档于2015-06-17）.
^ 李巍. 特应性皮炎与过敏进程. 医学与哲学. 2014, 35 (6B): 12–14.
^ Environmental Allergies: Symptoms. NIAID. April 22, 2015 [19 June 2015]. （原始内容存档于2015-06-18）.
^ Bahna SL. Cow's milk allergy versus cow milk intolerance.. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. Dec 2002, 89 (6 Suppl 1): 56–60. PMID 12487206. doi:10.1016/S1081-1206(10)62124-2.
^ ^16.0 ^16.1 ^16.2 National Institute of Allergy and Infectious Diseases. Food Allergy An Overview (PDF). July 2012. （原始内容 (pdf)存档于2015-07-27）.
^ van Ree R, Poulsen LK, Wong GWK, Ballmer-Weber BK, 高中山, 贾旭东. 食物过敏的定义、流行性、诊断及治疗. 中华预防医学杂志. 2015, 49 (1): 87–92. doi:10.3760/cma.j.issn.0253-9624.2015.01.020.
^ ^18.0 ^18.1 Kay AB. Overview of 'allergy and allergic diseases: with a view to the future'. Br. Med. Bull. 2000, 56 (4): 843–64. PMID 11359624. doi:10.1258/0007142001903481.
^ How Does an Allergic Response Work?. NIAID. April 21, 2015 [20 June 2015]. （原始内容存档于2016-09-09）.
^ Cox L, Williams B, Sicherer S, Oppenheimer J, Sher L, Hamilton R, Golden D. Pearls and pitfalls of allergy diagnostic testing: report from the American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force. Annals of Allergy, Asthma & Immunology. December 2008, 101 (6): 580–92. PMID 19119701. doi:10.1016/S1081-1206(10)60220-7.
^ Allergy Frequently Asked Questions. www.allergicliving.com. [2020-10-14]. （原始内容存档于2021-05-01）（英语）.
^ ^22.0 ^22.1 Sicherer, SH.; Sampson, HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment.. J Allergy Clin Immunol. Feb 2014, 133 (2): 291–307; quiz 308. PMID 24388012. doi:10.1016/j.jaci.2013.11.020.
^ Trends in Allergic Conditions Among Children: United States, 1997–2011. [2016-02-08]. （原始内容存档于2021-04-23）.
^ ^24.0 ^24.1 Allergen Immunotherapy. April 22, 2015 [15 June 2015]. （原始内容存档于2016-09-09）.
^ ^25.0 ^25.1 Simons FE. Anaphylaxis: Recent advances in assessment and treatment (PDF). The Journal of Allergy and Clinical Immunology. October 2009, 124 (4): 625–36; quiz 637–8 [2015-07-13]. PMID 19815109. doi:10.1016/j.jaci.2009.08.025. （原始内容存档 (PDF)于2013-06-27）.
^ Barczok M. Neue Leitlinie zur Allergieprävention: So beraten Sie Ihre Patienten richtig.. MMW - Fortschritte der Medizin. 2015-03, 157 (5): 65–66. doi:10.1007/s15006-015-2828-5.
^ Allergic Diseases. NIAID. May 21, 2015 [20 June 2015]. （原始内容存档于2015-06-18）.
^ Wheatley, LM; Togias, A. Clinical practice. Allergic rhinitis.. The New England journal of medicine. 29 January 2015, 372 (5): 456–63. PMID 25629743.
^ Thomsen, SF. Atopic dermatitis: natural history, diagnosis, and treatment.. ISRN allergy. 2014, 2014: 354250. PMID 25006501.
^ Global Strategy for Asthma Management and Prevention (PDF). Global Initiative for Asthma: 2–5. 2011 [2015-07-13]. （原始内容存档 (PDF)于2012-11-20）.
^ Leslie C. Grammer. Patterson's Allergic Diseases 7. 2012 [2015-07-13]. ISBN 9781451148633. （原始内容存档于2015-06-20）.
^ Anandan C, Nurmatov U, van Schayck OC, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy. February 2010, 65 (2): 152–67. PMID 19912154. doi:10.1111/j.1398-9995.2009.02244.x.

外部链接

[1] 《英汉汉英医学大词典》编委会. 英汉汉英医学大词典. 学苑出版社. 1997: 19. ISBN 9787507711585.

[2] 王建东, 王怀立. 《欧洲变态反应与临床免疫学会严重过敏反应指南2021版》解读 [J] . 中国小儿急救医学, 2022, 29(4) : 260-265. DOI: 10.3760/cma.j.issn.1673-4912.2022.04.005.

[3] 乔燕.益生菌对变应性疾病作用机制的研究进展[J].临床耳鼻咽喉头颈外科杂志, 2016, 30(18):5.DOI:10.13201/j.issn.1001-1781.2016.18.018.

[4] 何韶衡.以过敏性疾病发病机制为基础浅析其辅助诊断手段及临床意义[J].中华临床免疫和变态反应杂志, 2011, 05(001):1-4.DOI:10.3969/j.issn.1673-8705.2011.01.001.

[5] 王莲芸.过敏性疾病的发病机理[C]//2017上海市医学会变态反应学术年会.;上海市医学会;;, 2017.

[6] 刘红,俞雨生.变态反应性疾病发病机制及其治疗[J].肾脏病与透析肾移植杂志, 2002, 11(2):6.DOI:10.3969/j.issn.1006-298X.2002.02.021.

[7] Janeway CA Jr, Travers P, Walport M, et al. Immunobiology: The Immune System in Health and Disease. 5th edition. New York: Garland Science; 2001. Chapter 12, Allergy and Hypersensitivity. Available from: https://www.ncbi.nlm.nih.gov/books/NBK10756/

[8] Hypersensitivity (Allergy). In: Levinson W, Chin-Hong P, Joyce EA, Nussbaum J, Schwartz B. eds. Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 16e. McGraw Hill; 2020. Accessed September 03, 2024. https://accessmedicine.mhmedical.com/content.aspx?bookid=2867&sectionid=242768630

[9] Hasan-Abad, A.M., Mohammadi, M., Mirzaei, H. et al. Impact of oligomerization on the allergenicity of allergens. Clin Mol Allergy 20, 5 (2022). https://doi.org/10.1186/s12948-022-00172-1

[Changgeng-10] 過敏反應—對無害物質產生的免疫反應. 长庚生物科技. [2014-08-07]. （原始内容存档于2019-08-23）.

[Con2007-11] 11.0 ^11.1 McConnell, Thomas H. The nature of disease : pathology for the health professions. Baltimore, Mar.: Lippincott Williams & Wilkins. 2007: 159 [2015-07-13]. ISBN 9780781753173. （原始内容存档于2020-12-22）.

[12] Types of Allergic Diseases. NIAID. May 29, 2015 [17 June 2015]. （原始内容存档于2015-06-17）.

[李巍-13] 李巍. 特应性皮炎与过敏进程. 医学与哲学. 2014, 35 (6B): 12–14.

[14] Environmental Allergies: Symptoms. NIAID. April 22, 2015 [19 June 2015]. （原始内容存档于2015-06-18）.

[15] Bahna SL. Cow's milk allergy versus cow milk intolerance.. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. Dec 2002, 89 (6 Suppl 1): 56–60. PMID 12487206. doi:10.1016/S1081-1206(10)62124-2.

[NIH2012pdf-16] 16.0 ^16.1 ^16.2 National Institute of Allergy and Infectious Diseases. Food Allergy An Overview (PDF). July 2012. （原始内容 (pdf)存档于2015-07-27）.

[vanRee-17] van Ree R, Poulsen LK, Wong GWK, Ballmer-Weber BK, 高中山, 贾旭东. 食物过敏的定义、流行性、诊断及治疗. 中华预防医学杂志. 2015, 49 (1): 87–92. doi:10.3760/cma.j.issn.0253-9624.2015.01.020.

[Kay2000-18] 18.0 ^18.1 Kay AB. Overview of 'allergy and allergic diseases: with a view to the future'. Br. Med. Bull. 2000, 56 (4): 843–64. PMID 11359624. doi:10.1258/0007142001903481.

[19] How Does an Allergic Response Work?. NIAID. April 21, 2015 [20 June 2015]. （原始内容存档于2016-09-09）.

[Cox2008-20] Cox L, Williams B, Sicherer S, Oppenheimer J, Sher L, Hamilton R, Golden D. Pearls and pitfalls of allergy diagnostic testing: report from the American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force. Annals of Allergy, Asthma & Immunology. December 2008, 101 (6): 580–92. PMID 19119701. doi:10.1016/S1081-1206(10)60220-7.

[21] Allergy Frequently Asked Questions. www.allergicliving.com. [2020-10-14]. （原始内容存档于2021-05-01）（英语）.

[Sic2014-22] 22.0 ^22.1 Sicherer, SH.; Sampson, HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment.. J Allergy Clin Immunol. Feb 2014, 133 (2): 291–307; quiz 308. PMID 24388012. doi:10.1016/j.jaci.2013.11.020.

[23] Trends in Allergic Conditions Among Children: United States, 1997–2011. [2016-02-08]. （原始内容存档于2021-04-23）.

[NIH2015Imm-24] 24.0 ^24.1 Allergen Immunotherapy. April 22, 2015 [15 June 2015]. （原始内容存档于2016-09-09）.

[Review09-25] 25.0 ^25.1 Simons FE. Anaphylaxis: Recent advances in assessment and treatment (PDF). The Journal of Allergy and Clinical Immunology. October 2009, 124 (4): 625–36; quiz 637–8 [2015-07-13]. PMID 19815109. doi:10.1016/j.jaci.2009.08.025. （原始内容存档 (PDF)于2013-06-27）.

[Barczok-26] Barczok M. Neue Leitlinie zur Allergieprävention: So beraten Sie Ihre Patienten richtig.. MMW - Fortschritte der Medizin. 2015-03, 157 (5): 65–66. doi:10.1007/s15006-015-2828-5.

[27] Allergic Diseases. NIAID. May 21, 2015 [20 June 2015]. （原始内容存档于2015-06-18）.

[NEJM2015-28] Wheatley, LM; Togias, A. Clinical practice. Allergic rhinitis.. The New England journal of medicine. 29 January 2015, 372 (5): 456–63. PMID 25629743.

[29] Thomsen, SF. Atopic dermatitis: natural history, diagnosis, and treatment.. ISRN allergy. 2014, 2014: 354250. PMID 25006501.

[GINA2011p2-30] Global Strategy for Asthma Management and Prevention (PDF). Global Initiative for Asthma: 2–5. 2011 [2015-07-13]. （原始内容存档 (PDF)于2012-11-20）.

[31] Leslie C. Grammer. Patterson's Allergic Diseases 7. 2012 [2015-07-13]. ISBN 9781451148633. （原始内容存档于2015-06-20）.

[32] Anandan C, Nurmatov U, van Schayck OC, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy. February 2010, 65 (2): 152–67. PMID 19912154. doi:10.1111/j.1398-9995.2009.02244.x.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]

[31]

[32]