알레르기 증상으로 내원한 한국인에서의 음식물 알레르겐에 대한 감작율 조사: 다기관 공동연구

김세훈 ( Kim Se Hun ),강혜련 ( Kang Hye Lyeon ),김경묵 ( Kim Gyeong Mug ),김태범 ( Kim Tae Beom ),김선신 ( Kim Seon Sin ),장윤석 ( Jang Yun Seog ),김철우 ( Kim Cheol U ),반준우 ( Ban Jun U ),김윤근 ( Kim Yun Geun ),조상헌 ( Jo San 대한천식알레르기학회 2003 천식 및 알레르기 Vol.23 No.3

학령기 아동의 식품알레르기 유병률과 식품 알레르겐 감작률 조사

이혜숙 ( Hye Sook Lee ),홍성철 ( Sung Chul Hong ),김정홍 ( Jeong Hong Kim ),김재왕 ( Jae Wang Kim ),이근화 ( Keun Hwa Lee ),이재천 ( Jae Chun Lee ) 대한보건협회 2014 대한보건연구 Vol.40 No.3

연구목적 : 본 연구는 학령기 아동의 식품알레르기 유병률과 식품 알레르겐의 감작률을 조사하고자 하였다. 연구방법 : 2011년 4월부터 5월까지 제주지역 3개 초등학교 1, 2학년 1,189명을 대상으로 ISSAC 설문지를 이용한 자기기 입식 설문조사와 12종의 식품 알레르겐에 대해 피부단자시험(Skin Prick Test)을 시행하였다. 연구결과 : 학령기 아동의 “평생 식품알레르기 증상 유병률(Food Allergy, ever)”은 10.5%, “최근 식품알레르기 증상 유병률 (Food Allergy, last 12 mo)” 4.8%, “평생 식품알레르기 진단 유병률 (Diagnosis of Food Allergy, ever)”5.8%, “최근 식품알레르기 치료 유병률(Treatment of Food Allergy, last 12 mo)” 2.6%로 타 지역 소아와 비슷한 수준을 보였다. 1개 이상의 식품알레르겐에 감작률을 보인 경우는 3.7%로 남자(4.8%)가 여자(2.5%)보다 감작률이 유의하게 높았다(p=0.043). 가장 높은 감작률을 보인 식품 알레르겐은 새우(1.1%), 계란흰자(0.6%), 홍합(0.5%), 계란노른자(0.4%), 우유(0.4%) 순이었으며, 식품알레르기증상 발생에 연관이 있는 알레르겐은 계란흰자, 계란노른자, 참치, 닭고기, 대두 등이었다. 다변량 분석결과, 식품알레르기 발생과 가장 관련이 있는 원인 식품은 계란이었으며, 계란에 감작되었을 때 식품알레르기 발생 위험도가 10.53배 높은 것으로 나타났다. 결론 : 제주지역 학령기 아동의 식품알레르기 유병률은 다른 지역과 큰 차이가 없었으나, 2008년도에 비해 증가 추세를 보였다. 가장 높은 감작률을 보인 것은 계란이었으며, 학령기 아동의 식품알레르기 발생의 주요 원인 식품으로 확인되었다. 추후에도 각 지역사회 혹은 학교단위 별로 식품알레르기에 대한 정기적인 역학조사와 함께 맞춤형 교육이 필요하다. Objectives : This study is to survey school-aged children``s prevalence of food allergy and to investigate sensitization rates to common food allergens. Methods : The self-administered questionnaire survey and skin prick tests with 12 food allergens were applied to school children in Jeju, Korea. From 3 elementary schools, 1,189 children were enrolled with informed consent. Results : The lifetime prevalence of self-reported food allergy were 10.5%. The period prevalence of self-reported food allergy(last 12 months), the lifetime prevalence of clinician-diagnosed food allergy and the period prevalence of clinician-treated food allergy(last 12 months) were 4.8%, 5.8% and 2.6%, respectively. The sensitization rate to one or more food allergens was 3.7%. Male(4.8%) showed more sensitized than female (2.5%)(p=0.043). Shrimps(1.1%), egg white(0.6%), mussels(0.5%), yolk(0.4%) and milk(0.4%) were commonly sensitized food allergens. The commonly associated allergens in the lifetime prevalence of food allergy include egg white, yolk, tuna, chicken and soybeans. The multivariate analysis revealed that the allergens most significantly related with the lifetime prevalence of food allergy were eggs, showing the risk of food allergy was 10.53 times higher in the cases with sensitization to egg. Conclusion : Compared to those in other regions, the school-aged children in Jeju show no difference in the prevalence of food allergy, but, with a gradual increase in frequency. Among the food allergens, egg is one of the most commonly sensitizing allergen as well as cause of food allergy. Serial epidemiological investigations and customized educational programs concerning food allergy are necessary at school.

Food allergy

Han, Young-Shin,Kim, Ji-Hyun,Ahn, Kang-Mo The Korean Pediatric Society 2012 Clinical and Experimental Pediatrics (CEP) Vol.55 No.5

Food allergy is an important public health problem affecting 5% of infants and children in Korea. Food allergy is defined as an immune response triggered by food proteins. Food allergy is highly associated with atopic dermatitis and is one of the most common triggers of potentially fatal anaphylaxis in the community. Sensitization to food allergens can occur in the gastrointestinal tract (class 1 food allergy) or as a consequence of cross reactivity to structurally homologous inhalant allergens (class 2 food allergy). Allergenicity of food is largely determined by structural aspects, including cross-reactivity and reduced or enhanced allergenicity with cooking that convey allergenic characteristics to food. Management of food allergy currently focuses on dietary avoidance of the offending foods, prompt recognition and treatment of allergic reactions, and nutritional support. This review includes definitions and examines the prevalence and management of food allergies and the characteristics of food allergens.

Food allergy

한영신,김지현,안강모 대한소아청소년과학회 2012 Clinical and Experimental Pediatrics (CEP) Vol.55 No.5

Food allergy is an important public health problem affecting 5% of infants and children in Korea. Food allergy is defined as an immune response triggered by food proteins. Food allergy is highly associated with atopic dermatitis and is one of the most common triggers of potentially fatal anaphylaxis in the community. Sensitization to food allergens can occur in the gastrointestinal tract (class 1 food allergy)or as a consequence of cross reactivity to structurally homologous inhalant allergens (class 2 food allergy). Allergenicity of food is largely determined by structural aspects, including cross-reactivity and reduced or enhanced allergenicity with cooking that convey allergenic characteristics to food. Management of food allergy currently focuses on dietary avoidance of the offending foods, prompt recognition and treatment of allergic reactions, and nutritional support. This review includes definitions and examines the prevalence and management of food allergies and the characteristics of food allergens.

유전자재조합식품의 알레르기 항원성 평가

고미선,윤소원,이하백,오재원 대한 소아알레르기 호흡기학회 2008 Allergy Asthma & Respiratory Disease Vol.18 No.4

Purposes:The aim of this study was to clarify whether genetically modified organic (GMO) foods cause any allergic reactions in patients with food allergy, by means of their serum tests. In addition, it was also attempted to perform follow-up observation on targeting proteins contained in GMO food, using the serum of patients with food allergy, and to show the improvement for evaluating GMO food as allergens. Methods:To identify the targeting proteins in GMO food and to evaluate their allergenic risks, several genes including CP4 EPSPS in genetically modified soybean, and Cry1f, Cry1Ab and Pat in genetically modified corn were cloned. The genes were transformed to synthesize proteins to induce protein expression of their target genes. The serums were divided allergy- positive and allergy-negative to soybean and corn, and SDS-PAGE and Western blotting were conducted, and finally allergenic risks were evaluated. Results:This study showed that the allergenic risks of 4 targeting proteins were insignificant. Although some non-specific bands appeared, it was considered that they were not associated with allergenic risk as they often appeared in other proteins. Additionally, as a result of analyzing DNA sequences for each targeting protein with the intention of protein identification, they perfectly matched. Conclusion:As a way to evaluate the allergenic risk of GMO food, it is reasonable to use the purified serum proteins of allergic patients as performed in this study. However, this evaluation method is carefully applied to the future practice. Purposes:The aim of this study was to clarify whether genetically modified organic (GMO) foods cause any allergic reactions in patients with food allergy, by means of their serum tests. In addition, it was also attempted to perform follow-up observation on targeting proteins contained in GMO food, using the serum of patients with food allergy, and to show the improvement for evaluating GMO food as allergens. Methods:To identify the targeting proteins in GMO food and to evaluate their allergenic risks, several genes including CP4 EPSPS in genetically modified soybean, and Cry1f, Cry1Ab and Pat in genetically modified corn were cloned. The genes were transformed to synthesize proteins to induce protein expression of their target genes. The serums were divided allergy- positive and allergy-negative to soybean and corn, and SDS-PAGE and Western blotting were conducted, and finally allergenic risks were evaluated. Results:This study showed that the allergenic risks of 4 targeting proteins were insignificant. Although some non-specific bands appeared, it was considered that they were not associated with allergenic risk as they often appeared in other proteins. Additionally, as a result of analyzing DNA sequences for each targeting protein with the intention of protein identification, they perfectly matched. Conclusion:As a way to evaluate the allergenic risk of GMO food, it is reasonable to use the purified serum proteins of allergic patients as performed in this study. However, this evaluation method is carefully applied to the future practice.

산업체에서의 식품 알레르기 관리

성동은,곽호석 한국산업식품공학회 2018 산업 식품공학 Vol.22 No.4

Food allergy is a chronic disease that is increasing all over the world, and it can even lead to a loss of life. To prevent any incidents resulting from food allergies, most countries keep strengthening their food allergen labeling requirements domestically and internationally, with a constant monitoring system against undeclared allergens and recall of offending products. In order to avoid economic losses to industry and damages to international relations from undeclared allergens, it is necessary to confirm each country’s regulatory policy on food allergen labeling prior to exportation. Another required action is to try for a reduction of the cross-contamination risk of the allergens during manufacturing and storage, which should be verified by using an accurate and reliable analysis of food allergens. This paper is intended to provide an introduction to the regulation of food allergen labeling by country, allergen management methods to avoid cross-contamination, and allergen detection methods using ELISA, PCR, and LC/ MS. Changes of allergenicity during thermal or nonthermal processing also will be investigated in our review. This review will be helpful for the food industry to better understand patients suffering from food allergies and to manage food allergens in food manufacturing.

한국인 음식물 의존성 운동유발 아나필락시스의 임상적 특성 분석

정수지 ( Soo Jie Chung ),심지수 ( Jisu Shim ),김형준 ( Hyung-jun Kim ),손경희 ( Kyoung-hee Sohn ),강성윤 ( Sung-yoon Kang ),강민규 ( Min-gyu Kang ),박한기 ( Han-ki Park ),강혜련 ( Hye-ryun Kang ) 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.6

Purpose: Food-dependent exercise-induced anaphylaxis (FDEIA) is a rare subtype of food allergy in which both sensitization to food allergen and exercise as a trigger contribute to its development. However, its pathogenesis is still under investigation. This study compared clinical features, the causative foods, and the degree of sensitization to food between FDEIA and food anaphylaxis to characterize FDEIA more clearly. Methods: We retrospectively reviewed the medical records of patients who were diagnosed with FDEIA (n=89) or food anaphylaxis (n=115) between 2003 and 2015 at Seoul National University Hospital. Results: Subjects with FDEIA more frequently had urticaria than those with food anaphylaxis (88.8% vs. 76.5%, P=0.024). Whereas patients with FDEIA had less laryngeal edema than those with food anaphylaxis (12.4% vs. 30.4%, P=0.02). Wheat (67.4%) was the most common causative food allergen in FDEIA, whereas seafood (40.9%) was the most common culprit food allergen in food anaphylaxis. Also, subjects with FDEIA showed a lower atopic index score than those with food anaphylaxis (0.55±1.07 vs. 1.21±1.82, P=0.006). Conclusion: There were significant differences in clinical manifestation, causative food allergens and the degree of sensitization to food between FDEIA and food anaphylaxis. (Allergy Asthma Respir Dis 2016:4:436-441)

식품 알레르기의 유병률과 알레르겐 분석

이계희(Kye-Hee Lee) 한국농촌의학 지역보건학회 2014 농촌의학·지역보건 Vol.39 No.1

식품 알레르기에 대한 유병률과 알레르기를 일으키는 식품의 종류를 알아내기 위해, 설문지 조사와 피부단자시험을 실시하였고, 또한 최근 국내외 식품 알레르기에 대한 자료 고찰을 하였다. 본 연구결과 설문지에 의한 성별 식품 알레르기증상 유병률은 남자에서는 25.6%, 여자는 5.8%로 남녀 간에 별 차이가 없었으며, 연령별로는 남자는 40-49세가 31.8%, 여자에서는 30-39세가 32.6%로 가장 높았다. 성별과 식품 항목에 의한 식품 알레르기의 유병률은 남자는 고등어가 6.6%로 가장 높았고, 여자는 복숭아가 7.4%로 가장 높았다. 성별에 의한 식품 알레르기 증상 유병자 중 피부단자시험 양성률을 보면 남자에서 21.4%의 양성률을, 여자에 있어서는 14.7%의 양성률을 나타내 남녀간의 유의한 차이(p=0.018)가 있었다. 식품 항목별 양성률을 보면 남자에서는 호프가 58.9%로 가장 높았고, 여자에서는 계란이 36.4%로 가장 높은 양성률을 나타냈으며, 돼지고기, 새우·가재, 호프, 그리고 토마토에서 통계적으로 남녀 간 유의한 차이가 있었다(p<0.05). 피부단자시험을 통하여 우리나라 식품 알레르기 증상 추정 유병률은 남자 5.0%, 여자 3.6%였으며, 알레르기를 일으키는 흔한 식품으로는 호프, 고등어, 새우, 가재, 게, 돼지고기, 우유, 계란 등이 포함된다고 생각한다. 최근 국내외 식품 알레르기에 관한 자료 분석에서 식품 알레르기 유병률은 1-35% 범위로 나타났으며, 알레르기를 일으키는 주요 식품은 우유, 계란, 견과류, 생선, 조개, 갑각류 그리고 과일 채소 등으로 확인 하였다. 따라서 본 연구는 지역사회 전 연령층을 대상으로 그리고 최근 국내외 식품 알레르기에 관한 자료를 분석한 첫 시도로써 향후 우리나라 식품 알레르기 질환을 예방하고 치료하는데 근거자료의 토대가 될 것이다. 또한 식품 알레르기 교육프로그램을 계획할 때는 식품알레르기의 유병률과 알레르겐을 포함한 대처방안이 필요하다고 본다. Objectives: The purpose of this study was to estimate the prevalence of food allergies and find out food allergens. Methods: Questionnaires were completed by 2,415 subjects in D city, among whom 452 subjects believed that they had food allergy. Skin prick tests were performed on these subjects. The data were analyzed using SAS Version 9.0 and χ²-test. In addition, several recent studies were reviewed. Results: The prevalence rate of food allergic symptoms was 25.6% in males and 25.8% in females, respectively. The positive rate of skin prick tests among those who were allergic to any of 14 food items was 21.4% in males and 14.7% in females(p=0.018). Therefore, it was estimated that the prevalence rate of food allergy was 5.0% in males and 3.6% in females. It was shown that the major food allergens were hop, shrimp, lobster, oyster and egg(whole) in males, and egg(whole), hop, oyster, and pork in females, respectively. The prevalence in recent studies ranged from 1 to 35%. Major food allergens were milk, egg, nuts, fish, shellfish crustacean and fruits/vegetables. Conclusions: In order to provide effective care for food allergy, it is essential to find out the prevalence of food allergies and food allergens.

IgE Sensitization Patterns to Commonly Consumed Foods Determined by Skin Prick Test in Korean Adults

김성렬,박혜정,박경희,이재현,박중원 대한의학회 2016 Journal of Korean medical science Vol.31 No.8

Offending food allergens can vary with regional preferences in food consumption. In this study, we analysed sensitization rates to commonly consumed foods in Korean adults suspected of having food allergy. One hundred and thirty four subjects underwent a skin prick test (SPT) with 55 food allergens, of which 13 were made by our laboratory and the rest were commercially purchased. Of the 134 patients, 73 (54.5%) were sensitized to one or more food allergens. Sensitization to chrysalis was detected most frequently, at a rate of 25.4%. Sensitization rates to other food allergens were as follows: maize grain (13.4%), shrimp (11.9%), almond (11.1%), wheat flour (8.2%), lobster (8.2%), buckwheat (8.2%), mackerel (5.2%), pollack (5.2%), halibut (4.5%), peanut (4.5%), anchovy (4.4%), squid (3.7%), saury (3.0%), common eel (3.0%), yellow corvina (3.0%), hairtail (2.2%), octopus (2.2%), and others. In addition to well-known food allergens, sensitivity to mackerel, chrysalis, pollack, and halibut, which are popular foods in Korea, was observed at high rates in Korean adults. We suggest that the SPT panel for food allergy in Korea should include these allergens.

우유의 알레르기 유발물질

김소영 ( So Young Kim ),오상석 ( Sang Suk Oh ),함준상 ( Jun Sang Ham ),설국환 ( Kuk Hwan Seol ),김현욱 ( Hyoun Wook Kim ),한상하 ( Sang Ha Han ),최은영 ( Eun Young Choi ),박범영 ( Beom Young Park ),오미화 ( Mi Hwa Oh ) 한국유가공기술과학회 2012 Journal of Dairy Science and Biotechnology (JMSB) Vol.30 No.1

Since the prevalence of allergies is increasing, food allergy is a major concern for consumers, as well as for the food industry. The foods that account for over 90% of all moderate to severe allergic reactions to food are milk, eggs, peanuts, soybeans, fish, shellfish, wheat, and tree nuts. Of these food allergens, milk is one of the major animal food allergens in infants and young children. Milk is the first food that an infant is exposed to; therefore, the sensitization rate of milk in sensitive individuals is understandably higher. The mechanisms involved in allergic reactions caused by this hypersensitivity are similar to those of other immune-mediated allergic reactions. The reactions occur in the gastrointestinal tract, skin, and respiratory tract, with headaches and psychological disorders occurring in some instances. The major allergenic proteins in milk are casein, β-lactoglobulin, and α-lactalbumin, while some of the minor allergenic proteins are lactoferrin, bovine serum albumin, and immunoglobulin. Reliable allergen detection and quantification are essential for compliance with food allergen-labeling regulations, which protect the consumer and facilitate international trade.