原標(biāo)題：食物過敏和過敏反應(yīng)-2044 熱帶地區(qū)蝦過敏中，基于組份的過敏原敏感性概況
　　評價(jià)一組蝦過敏患者對塵螨、蝦過敏原和原肌球蛋白的致敏性，用ImmunoCAP和 ImmunoCAP ISAC生物芯片定量檢測105例樣本的血清過敏原特異性IgE，根據(jù)確切的臨床病史和對斑節(jié)對蝦和凡納濱對蝦的食物激發(fā)試驗(yàn)結(jié)果將受試者進(jìn)行分類。1A組：對兩種蝦的食物激發(fā)試驗(yàn)陽性（22例）或因嚴(yán)重的蝦過敏反應(yīng)送急診但未進(jìn)行食物激發(fā)試驗(yàn)（14例）（總計(jì)36例）；1B組：報(bào)道為蝦過敏但食物激發(fā)試驗(yàn)為陰性（31例）；2組：貝類耐受塵螨敏感對照樣本（38例）  105例樣本除1例外均對三種塵螨(屋塵螨, 粉塵螨, 熱帶無爪螨)中的至少一種敏感，致敏率最高的是Blo t 5，接著是Der f 1，塵螨和蝦的原肌球蛋白有高度的相關(guān)性(p<0.001)，與1B組相比，1A組的原肌球蛋白致敏率更高(Der p 10 [33.3%vs9.7%]，Pen m 1 [33.3%vs9.7%] p<0.037)，與2組相比，(Blo t 10 [19.4%vs0%], Pen m 1 [33.3%vs5.3%], Pen I 1 [27.8%vs5.3%], Lit v 1 [22.2%vs5.3%], p<0.05).與1B組(6.5%)和2組(5.2%)相比，1A組(22.2%)對Lit v 2的致敏率更高(p<0.093). Lit v 3, 4的致敏率低（<10%）。 蝦組（ImmunoCAP f24）檢測陽性+所有原肌球蛋白+所有蝦過敏原來區(qū)分食物激發(fā)試驗(yàn)的陰陽性敏感性最高（81.8%），但是特異性低只有24.1%。Der p 10或任何蝦原肌球蛋白陽性來判斷蝦過敏的特異性最高（93.1%），但敏感性低（31.8%）原肌球蛋白在物種之間存在高度交叉反應(yīng)，并與熱帶蝦過敏有顯著的相關(guān)性，ISAC Immunocap提高了檢測食物激發(fā)陽性和蝦過敏的準(zhǔn)確性。
　　延伸閱讀


World Allergy Organization journal
Food allergy and anaphylaxis – 2044. Component resolved allergen sensitzation profiles in shrimp allergy in the tropics
DOI:org/10.1186/1939-4551-6-S1-P129
Abstract:
Background:Shellfish allergy is one of the commonest food allergies in the tropics.
Methods:Serum allergen-specific IgE of 105 subjects were quantified using ImmunoCAP and ImmunoCAP ISAC biochips. The subjects were classified based on a convincing clinical history and food challenge testing (FC) (dose=70g) to Penaeus monodon and Litopenaeus vannamei. Group1A: Either SA with FC positive to either shrimp (n =22) or SA admitted to emergency departments for severe reactions but no FC performed (n=14) (total n=36); and Group1B: Reported SA with FC negative (n=31). Group2: Shellfish tolerant DM sensitized controls (n= 38).
Results:All 105 subjects but one were sensitized to at least one of 3 DM tested (Dermatophagoides pteronyssinus, Dermatophagoides farina, Blomia tropicalis), with highest sensitization rates to Blo t 5 followed by Der f 1. DM and shrimp tropomyosin showed high correlation (p<0.001). Group1A had higher rates of sensitization to tropomyosins compared to Group1B (Der p 10 [33.3%vs9.7%], and Pen m 1 [33.3%vs9.7%], p<0.037); and to Group2 (Blo t 10 [19.4%vs0%], Pen m 1 [33.3%vs5.3%], Pen I 1 [27.8%vs5.3%], Lit v 1 [22.2%vs5.3%], p<0.05). Sensitization to Lit v 2 were higher in Group1A (22.2%) compared to Group1B (6.5%) and Group2 (5.2%) (p<0.093). The sensitization rates to Lit v 3, 4 were low (<10%). A positive test for a combination of shrimp (ImmunoCAP f24)+any tropomyosin+any shrimp allergens gave the highest sensitivity(81.8%) to distinguish FC positive from negative subjects but had a low specificity of 24.1%. The specificity was highest (93.1%) when using a positive test for Der p 10 or any shrimp tropomyosin, but sensitivity was low (31.8%).
Conclusions:Tropomyosins are highly cross reactive across species and is significantly associated with SA in the tropics. ISAC Immunocap improved the accuracy to detect FC+ve SA.
All Authors:
Irenaeus Paul Chia
Correspondence:
National University of Singapore, Singapore
All Authors:
Irenaeus Paul Chia, Gaik Chin Yap, Bee Wah Lee, Hugo Van Bever, Lynette Shek Pei-Shi, Irvin Francis A Gerez, Genevieve Llanora, Yew Kuang Cheng, Bernard Thong, MA Curotto De Lafaille, Chwee Ying Tang
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺。