Peran Alergi Makanan dan Alergen Hirup pada Dermatitis Atopik
Sari
Sensitisasi makanan dan aeroalergen memegang peran pada patogenesis penyakit atopik
seperti dermatitis atopik (DA), rinitis alergik dan asma. Dermatitis atopik merupakan
suatu penyakit kronik yang tidak dapat disembuhkan 100% dan sering mengalami
eksaserbasi, serta menimbulkan masalah pada orang tua dan dokter. Banyak faktor yang
berperan pada DA, baik faktor eksogen atau endogen maupun kombinasi keduanya.
Faktor genetik merupakan salah satu faktor yang berperan pada DA. Faktor eksogen
seperti makanan aeroalergen banyak dilaporkan sebagai pencetus timbulnya DA. Masih
terdapat perbedaan pendapat mengenai makanan sebagai penyebab tetapi terdapat bukti
bahwa bila makanan dihindarkan gejala dermatitis membaik. Susu sapi memprovokasi
gejala DA pada usia bayi1 dan 30% DA disebabkan alergi susu sapi2.
Alergen hirup seperti tungau debu rumah berperan pada patogenesis DA, terutama
pada anak; hal ini berdasarkan beberapa pengamatan klinis, uji kulit dan IgE spesifik
yang tinggi serta terdapat perbaikan gejala klinis DA setelah penghindaran tungau debu
rumah.3 Alergen makanan lebih berpengaruh pada usia bayi kurang dari 1 tahun
sedangkan aeroalergen pada usia di atas 2 tahun.4 H asil penelitian di Departemen IKA
RSCM menunjukkan bahwa DA pada anak dengan onset kurang dari 1 tahun yang
telah tersensitisasi telur dan aeroalergen akan meningkatkan risiko alergi saluran napas
di kemudian hari sampai sepuluh kali lipat
Kata Kunci
Teks Lengkap:
PDFReferensi
Hattevig G, Kjellman B, Bjorksten B, Johansson SGO.
Clinical symptoms and IgE responses to common food
proteins in atopic and healthy children. Clin Allergy
; 14:551-7.
Lebenthal F. Cow’s milk protein allergy. Pediatr Clin
North Am 1975; 22:827-33.
Chapman RD, Rountrees S, Mitchell EB. Quantitative
assessment of IgG and IgE antibodies to inhalants allergen
in patients with atopic dermatitis. J Allergy Clin
Immunol 1983; 72:27-31.
Escarrer JM,Munoz-LopezF. Role of aeroallergens in the
etiopathogenesis of atopic dermatitis. Allergol
Immunolpathol, 2002; 30:126-34.
Sjawitri P Siregar, Bambang Madiyono, Amar W
Adisasmito. Risk factors of respiratory allergy in children
with atopic dermatitis. Paediatr Indones 1999;
:134-44.
Kondo N, Fukutomi O, Agata H. The role of T lymphocytes
in patients with food sensitive atopic dermatitis.
J Allergy Clin Immunol 1993; 91:658-68.
Neaville WA, Tisler C, Bhattacharya A, Anklam K,
Gilberston-White S, Hamilton R, dkk. Developmental
cytokine response profiles and the clinical and immunologic
expression of atopy during the first year of life.
J Allergy Clin Immunol 2003; 112:740-6.
Van Asperen PP, Kemp AS. The natural history of IgE
sensitization and atoipic disease in early childhood. Acta
Paediatr Scand 1989; 78:239-45.
Nickel R, Kulig M, Foster J. Sensitisation to hen’s egg at
age of twelve months is predictive for allergenic sensitization
to common indoor and outdoor allergens at the age
of three years. J Allergy Clin Immunol 1997; 99:613-7.
Vasar M, Julge K, Bjoksto B. Development of atopic
sensitization and allergic diseases in early childhood. Acta
Paediatr 2000; 89:523-7.
Beck LA, Leung DY. Allergen sensitization through the
skin induces systemic allergic responses. J Allergy Clin
Immunol 2000; 106:S258-63.
Albert JO, Marjolein S de Bruin-Weller, Ingrid T,Zana
TP, Rob CA, Jan GR de Monchy, dkk. Effect of mattress
encasings on atopic dermatitis outcome measures
in a double-blind, placebo-controlled study : The Dutch
mite avoidance study. J Allergy Clin Immunol 2002;
:500-6.
Hanifin JM. Atopic dermatitis. JK Allergy Clin Immunol
; 73:211-26.
Sampson HA.Food sensitivity and the pathogenesis of
atopic dermatitis. JR Soc Med 1997; 90:2-8.
Hill DJ, Sporik R, Thornburn J, Hosking CS. The association
of atopic dermatitis in infancy with immunoglobulin
E food sensitization. J Pediatr 2000; 137:475-9.
Hanifin JM. Atopic dermatitis in infants and children.
Pediatr Clin North Am, 1991; 38:763-89.
Eigenmann PA, Sicherer SH, Borkowski TA, Cohen BA,
Sampson HA. Prevalence of IgE mediated food allergy
among children with atopic dermatitis. J Pediatrs, 1987;
-4.
Hoffman DR. Immunochemical identification of allergens
in egg white. J Allergy Clin Immunol 1983; 71:481-6.
Langland T: A clinical and immunological study of allergy
to hen’s egg white. Occurance of proteins crossreactivity
with allergens in hen’s egg white as studied in
egg white from turkey, duck, goose, seagull and in hen’s
egg yolk, and hen and chicken sera and flesh. Allergy,
; 38:399-412.
Lee Bee Wah. Food and aeroallergen in atopy. 3rd Regional
scientific meeting on Paediatric Dermatollogy;
Singapura; November 1999.
Eigenmann P, Siecherer S, Borowski T, Cohen B, Sampson
HA. Prevalence of IgE-mediated food allergy among children
with atopic dermatoitis. Pediatrics 1998; 101:8-13.
Niggemann B, Sielaff B, beyer K, Binder C, Wahn U.
Outcome of double-blind, placebo-controlled food challenge
test in 107 children with atopic dermatitis. Clin
Exp Allergy, 1999; 29:91-6.
Julge K, Vasar M, Bjorksten B. Development of allergy
and IgE antibodies during the first five years of life in
Estonian children. Clin Exp Allergy 2001; 31:1854-61.
Schafer T, Heinrich J, Wjst M, Ring J, Wichmann HE.
Association between severity of atopic eczema and degree
of sensitization to aeroallergens in schoolchildren.
J Allergy Clin Immunol 1999; 104:1280-4.
Oranye AP, Wolkersytorfer A, de Waard-van der Spek
FB. Natural course of cow’s milk allergy in childhood
atopic eczema/dermatitis syndrome. Ann Allergy Asthma
Immunol 2002; 89:52-5.
DOI: http://dx.doi.org/10.14238/sp6.4.2005.155-8
Refbacks
- Saat ini tidak ada refbacks.
##submission.copyrightStatement##
##submission.license.cc.by-nc-sa4.footer##
Email: editorial [at] saripediatri.org
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.