The journal of allergy and clinical immunology. In practice · 2025
The Role of IgE Sensitization in Acute FPIES: A Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Phelan Aisling K, Infante Sonsoles, Barni Simona, Nurmatov Ulugbek, Boyle Robert J, Vazquez-Ortiz Marta
Аннотация
BACKGROUND: Evidence on the role of immunoglobulin E (IgE) sensitization in acute food protein-induced enterocolitis syndrome (atypical FPIES) is limited. Initial reports claimed association with persistent disease; however, recent studies have not replicated this.
OBJECTIVE: To systematically review the relationship between sensitization to the culprit food(s) in acute FPIES and the outcome of follow-up oral food challenges. To assess the rates of sensitization, seroconversion (ie, switch from negative tests to sensitization), and phenotype switch to IgE-mediated food allergy over time in individuals with acute FPIES.
METHODS: Systematic review searching 10 databases. Studies of children and adults with an acute FPIES diagnosis assessing IgE sensitization to a culprit food at onset or follow-up measured by skin prick or serological test were included.
RESULTS: Of 1,830 studies identified, 53 were eligible including 3,514 participants. Ten studies had an analytical design assessing whether sensitization was associated with disease persistence, with 4 showing an association and 6 showing no association. In individuals with acute FPIES, the sensitization rate was 9.8% (95% confidence interval [95% CI 7.4%-12.1%; 34 studies, 2,587 participants, I2 = 82%); the frequency of seroconversion was 1.1% (95% CI 0.1%-2.1%; 9 studies, 673 participants, I2 = 32%); and phenotype switch occurred in 1.1% (95% CI 0.4%-1.7%; 14 studies, 935 participants, I2 = 0%) and 13% (95% CI 5.5%-20.5%, 12 studies, 93 participants; I2 = 18%) of sensitized participants.
CONCLUSIONS: We did not find consistent evidence for the relationship between IgE sensitization and FPIES persistence. We found phenotype switch to IgE-mediated food allergy is uncommon in acute FPIES. An IgE sensitization in FPIES does not have a clear relationship with clinical outcomes.
OBJECTIVE: To systematically review the relationship between sensitization to the culprit food(s) in acute FPIES and the outcome of follow-up oral food challenges. To assess the rates of sensitization, seroconversion (ie, switch from negative tests to sensitization), and phenotype switch to IgE-mediated food allergy over time in individuals with acute FPIES.
METHODS: Systematic review searching 10 databases. Studies of children and adults with an acute FPIES diagnosis assessing IgE sensitization to a culprit food at onset or follow-up measured by skin prick or serological test were included.
RESULTS: Of 1,830 studies identified, 53 were eligible including 3,514 participants. Ten studies had an analytical design assessing whether sensitization was associated with disease persistence, with 4 showing an association and 6 showing no association. In individuals with acute FPIES, the sensitization rate was 9.8% (95% confidence interval [95% CI 7.4%-12.1%; 34 studies, 2,587 participants, I2 = 82%); the frequency of seroconversion was 1.1% (95% CI 0.1%-2.1%; 9 studies, 673 participants, I2 = 32%); and phenotype switch occurred in 1.1% (95% CI 0.4%-1.7%; 14 studies, 935 participants, I2 = 0%) and 13% (95% CI 5.5%-20.5%, 12 studies, 93 participants; I2 = 18%) of sensitized participants.
CONCLUSIONS: We did not find consistent evidence for the relationship between IgE sensitization and FPIES persistence. We found phenotype switch to IgE-mediated food allergy is uncommon in acute FPIES. An IgE sensitization in FPIES does not have a clear relationship with clinical outcomes.