过敏

過敏
過敏
	蕁麻疹是一種常見的過敏症狀。
类型	immunoglobulin mediated immune response[*]、超敏反應、疾病
病因	过敏原
分类和外部资源
醫學專科	免疫學
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]

過敏（英語：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]。

過敏原因子一般為人體接觸環境中對人毒性不大的物質^[10]^[11]，人體對於某些過敏原過度反應的現象，包含過敏性鼻炎、食物過敏、蕁麻疹、異位性皮膚炎、哮喘與全身型過敏性反應等^[12]^[13]；症狀可能有紅眼、引起搔癢的皮疹、流鼻水、呼吸困難與腫脹等^[14]。食物耐受不佳與食物中毒是兩種不一樣的現象^[15]^[16]。

常見的過敏原有食物和花粉^[17]。金屬和其他物質也可能引發過敏^[11]。食物、蚊蟲叮咬和藥物常造成嚴重的過敏反應。症狀的發展同時取決於遺傳和環境^[18]。過敏的原始機制是IgE抗體，會與過敏原結合，並釋放組織胺等引起發炎的化學物質^[19]。過敏的確診通常依據病患的醫療史進行判斷。特定病例必須進行皮肤试验或血液检查做進一步判定^[16]。然而，檢驗結果為陽性，並不代表所檢驗的過敏原就是引發過敏的單一物質^[20]。蜜蜂、黃蜂、火蟻是主要引起過敏反應的昆蟲^[21]。

在幼年時期，暴露在常見的過敏原也許具有保護作用^[22]。美國1997-2011年間對18歲以下兒童進行調查，各年齡組間食物過敏患病率無差異顯著。然而，皮膚過敏隨著年齡的增加而下降，而呼吸道過敏隨著年齡的增加而增加^[23]。過敏的治療包括：避開已知的過敏原和使用皮質類固醇與抗組織胺藥^[24]。嚴重過敏時，應緊急靜脈注射腎上腺素^[25]。所謂的過敏原免疫療法（英语：Allergen immunotherapy），是一種治療方法，該治療方法將病人暴露在逐漸增量的過敏原下，常用在某些特定的過敏疾病，像是乾草熱或是昆蟲叮咬^[26]。過敏原免疫療法對於食物過敏的效果尚不明^[24]。

過敏是相當常見的症狀^[27]。在發達國家，大約20%的人被過敏性鼻炎所困擾^[28]，大約6%的人至少有過一次食物過敏的經驗^[16]^[22]，有將近20%的人，一生之中至少經歷一次異位性皮膚炎^[29]。依據國家的不同，有 1%到18%的人有氣喘的症狀^[30]，0.05%到2%的人會經歷全身性過敏^[31]。許多過敏性的疾病的比例有上升的趨勢^[25]^[32]。1906年，克萊門斯·馮·皮爾奎（英语：Clemens von Pirquet）首次使用「allergy」這個字來命名過敏^[18]。

傳統觀念上會認為過敏是因為體內抵抗力太低，實際上過敏是一項人體對外界物質的過度反應現象，跟抵抗力低下並無關聯。多數過敏反應都是人體對無害物質所產生的排斥現象。會依照個體的不同而對於不同物質產生過敏，也因此並非所有過敏患者，都對同項物質產生過敏現象，所以才會通過過敏原檢測的方式，來檢視各個過敏患者的過敏物質。

超敏反應

超敏反應（hypersensitivity）分為四型：第I型為即發性超敏反應（immediate），它也叫作IgE介导型超敏反应、第II型為抗體依賴型和細胞毒殺超敏反應（antibody-dependent cytotoxic）、第III型為免疫複合體媒介超敏反應（immune complex-mediated ）、第IV型為遲發性超敏反應（delayed-type）。

而過敏（allergy）屬於第I型超敏反應；唯一例外是過敏性接觸性皮膚炎，此为历史误认为“变应性”反应，其病理生理学其实更准确地对应于第IV型超敏反应^[33]。在IV型超敏反应中，会激活CD8+T细胞，它们会在接触后破坏靶细胞，同时此反应也会激活巨噬细胞，进而产生水解酶^[34]。

過敏性疾病

參看

參考資料

^ 《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. 長庚生物科技. [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.
^ Martín A, Gallino N, Gagliardi J, Ortiz S, Lascano AR, Diller A, Daraio MC, Kahn A, Mariani AL, Serra HM. Early inflammatory markers in elicitation of allergic contact dermatitis. BMC Dermatology. August 2002, 2: 9. PMC 122084 . PMID 12167174. doi:10.1186/1471-5945-2-9 .
^ Hou, Wanzhu; Xu, Guangpi; Wang, Hanjie. Basic immunology and immune system disorders. Treating Autoimmune Disease with Chinese Medicine. Elsevier. 2011: 1–12. ISBN 978-0-443-06974-1. doi:10.1016/b978-0-443-06974-1.00001-4.

外部連結

[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. 長庚生物科技. [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.

[33] Martín A, Gallino N, Gagliardi J, Ortiz S, Lascano AR, Diller A, Daraio MC, Kahn A, Mariani AL, Serra HM. Early inflammatory markers in elicitation of allergic contact dermatitis. BMC Dermatology. August 2002, 2: 9. PMC 122084 . PMID 12167174. doi:10.1186/1471-5945-2-9 .

[34] Hou, Wanzhu; Xu, Guangpi; Wang, Hanjie. Basic immunology and immune system disorders. Treating Autoimmune Disease with Chinese Medicine. Elsevier. 2011: 1–12. ISBN 978-0-443-06974-1. doi:10.1016/b978-0-443-06974-1.00001-4.

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