据估计，18%的女性和6%的男性患有偏头痛，因此，偏头痛是一种普遍的精神科疾病[1]。目前，偏头痛不仅面临着诊断和治疗方面的挑战，还对患者的生活质量造成严重影响。偏头痛的特征是反复发作的单侧头痛，通常伴有恶心、呕吐、畏光、和/或恐音症。急性偏头痛的治疗选择应基于头痛的严重程度、频率、相关症状、合并症及完整的临床病史[2-4]。由于疼痛和/或炎症与某些临床症状的关系，致使医生怀疑免疫机制与头痛或偏头痛之间存在联系。
目前，已知即时食物过敏会产生全身和器官特异性功能障碍，这可能是IgE介导的。最近很少有研究报道，头痛和偏头痛是由IgG介导的晚期过敏反应，大多数严重的过敏反应都是由IgE介导[5-8]。偏头痛流行病学研究表明，在美国，10～20%的偏头痛是由食物引起的,即食物过敏性偏头痛.这些偏头痛有的完全是进食某种食物引起的,有的是进某种食物后又遇一些其他因素,如紧张和疲劳等后才发病的.这种疾病在亚洲的流行率一直低于白种人，亚洲人的偏头痛仅为高加索人的20%~50%[9]。在大多数患者中，IgE介导的食物过敏机制已被证实，但也有病例表明，消除IgG抗体介导的食物对偏头痛患者有帮助[10-13]。
在过去的几年里，我们的研究重点是食物的IgG抗体，作为后期过敏反应的原因。Carlos等[14]对传统治疗方法难治的复发性偏头痛患者进行了IgG抗体介导的食物过敏研究。结果显示，在剔除IgG抗体的食物一个月后，65例患者中有43人的偏头痛完全缓解。多年来，偏头痛和食物过敏的关系主要是通过IgE介导的机制而为人所知[5,8-15]。然而，很少有研究支持食物IgG介导的疾病的相关性[6,15-19]。在Atkinson等回顾临床病史的研究中，发现了6例患有偏头痛和结肠炎的病人经过1个月的剔除IgG抗体饮食，观察到两种疾病均得到明显改善，从而进一步证实胃肠道疾病与IgG食物过敏有关联[20-22]。Carlos等[14]排除患者含有IgG抗体的食物可能对控制偏头痛有益，尽管这些抗体也存在于健康个体中。研究表明，剔除IgG抗体饮食是确定良好预后的关键，在饮食治疗停止之前重新摄入含gG抗体饮食，偏头痛的症状再次出现[22]。
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Food allergy mediated by IgG antibodies associated with migraine in adults
参考文献
[1] Silberstein S.Practice parameter:evidence-based guidelines for migraine headache (an evidence-based review): report of the quality standards subcommittee of the American academy of neurology[J].Neurol,2000(55):754-762.
[2] Aukerman G,Knutson D,Miser W.Management of the acute migraine headache[J].Am Fam Physician,2002(66):2123-2130.
[3] Pascual J,Leno C.A woman with daily headaches[J].J Headache Pain,2005（6）:91-92.
[4] Smetana G.The diagnostic value of historical features in primary headache syndromes:a comprehensive review[J].Arch Intern Med,2000(160):2729-2737.
[5] Empl M,Straube A.The immune system and primary headache syndromes[J]. Anaesthesist,2001(50):783-791.
[6] Kniker W.Immunologically mediated reactions to food: state of the art[J].Ann Allergy,1987(59):60-70.
[7] Barnes R,Harvey M,Blears J,et al.IgG subclass of human serum antibodies reactive with dietary proteins[J].Int Arch Allergy Appl Immunol,1986(81)81:141-147.
[8] El Rafei A,Peters S,Harris N,et al.Diagnostic value of IgG4 measurements in patients with food allergy[J].Ann Allergy,1989(62):94-99.
[9] Stewart W,Lipton R,Liberman J.Variation in migraine prevalence by race[J]. Neurol,1996(47):52-59.
[10] Fordderreuthr S,Straube M,Heira R,et al.Diet and migraine[J].Neurol, 1996(9):534-538.
[11] Mansfield L,Vaughan T,Waller S,et al.Food allergy and adult migraine:double-blind and mediator confirmation of an allergic etiology[J].Ann Allergy,1985（55）:126-129.
[12] Praladier A,Launay J M.Immunological aspects of migraine[J].Biomed Pharmacother,1996(50):64-70.
[13] Empl M,Straube A.The immune system and primary headache syndromes[J]. Anaesthesist,2001(50):783-791.
[14] Carlos M,Arroyave Hernández,Mauro Echevarría Pinto,et al.Food allergy mediated by IgG antibodies associated with migraine in adults[J].Revista Alergia México,2007,54(5):162-168.
[15] Millichap J,Yee M.The diet factor in pediatric and adolescent migraine[J]. Pediatr Neurol,2003(28):9-15.
[16] Merrett J,Peatfield R,Rose F,et al.Food related antibodies in headache patients[J].J Neurol Neurosurg Psychiatry,1983(46):738-742.
[17] Cohen G,Hartman G,Hamburger R,et al.Severe anemia and chronic bronchitis associated with a markedly elevated specific IgG to cow’s milk protein[J]. Ann Allergy,1985(55):38-40.
[18] Morgan J,Daul C,Lehrer S.The relationships among shrimp-specific IgG subclass antibodies and immediate adverse reactions to shrimp challenge[J].J Allergy Clin Immunol,1990(86):387-392.
[19] Sampson H.Immunologically mediated food allergy:the importance of food challenge procedures[J].Ann Allergy,1988(60):262-269.
[20] Atkinson W,Sheldon T,Shaath N,et al.Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial[J].Gut,2004(53):1459-1464.
[21] Finn R,Smith M,Youngs G,et al.Immunological hypersensitivity to environmental antigens in the irritable bowel syndrome[J].Br J Clin Pract, 1987(41):1041-1043.
[22] Foster A,Knowles T,Moore A,et al.Serum IgE and IgG responses to food antigens in normal and atopic dogs, and dogs with gastrointestinal disease[J].Vet Immunol Immunopathol,2003(92)92:113-124.
