原標(biāo)題：中國(guó)北方地區(qū)嬰幼兒牛奶過(guò)敏的組份診斷研究
　　隨著中國(guó)乳制品消費(fèi)量的增加，牛奶過(guò)敏的發(fā)生率也不斷上升。本文分析了特異性免疫球蛋白E (sIgE)對(duì)不同牛奶蛋白的反應(yīng)情況，并對(duì)其在中國(guó)北方嬰幼兒牛奶過(guò)敏診斷中的價(jià)值進(jìn)行了評(píng)估。
　　收集48例牛奶過(guò)敏病人和27例陰性對(duì)照樣本的血清，用酶聯(lián)免疫法檢測(cè)針對(duì)α-乳白蛋白（Bos d 4），β-乳球蛋白（Bos d 5），α-酪蛋白（Bos d 9）, β-酪蛋白（Bos d 11）, and κ-酪蛋白（Bos d 12）的特異性IgE。
　　在牛奶過(guò)敏的人群中，大多數(shù)人至少對(duì)一種牛奶蛋白敏感;大約一半的人對(duì)Bos d 5、Bos d9、Bos d11和Bos d12分別敏感，而對(duì)Bos d 4血清sIgE陽(yáng)性的人很少。Bos d 12特異性IgE曲線下面積最大(AUC) (0.878;95% CI(0.800-0.957)，因此在鑒別牛奶過(guò)敏和非牛奶過(guò)敏患者方面表現(xiàn)出最好的診斷性能，使用統(tǒng)計(jì)學(xué)上最優(yōu)的cut-off值 (OD450nm, 0.191)，靈敏度為92.6%，特異性為72.9%。Bos d 5?+?Bos d 12的組合顯示AUC的值為0.926,它比任何單組份的都高。
　　我們的研究結(jié)果揭示了不同牛奶過(guò)敏原成分致敏的個(gè)體間差異。在牛奶過(guò)敏診斷中，Bos d 12特異性IgE表現(xiàn)最佳。應(yīng)用基于logistic回歸的ROC曲線，進(jìn)一步提高牛奶過(guò)敏原組份組合對(duì)牛奶過(guò)敏診斷的準(zhǔn)確性。


　　延伸閱讀


International Immunopharmacology:
Component resolved diagnostic study of cow's milk allergy in infants and young children in northern China
https://doi.org/10.1016/j.intimp.2018.05.027
Abstract:
Background
Increasing dairy consumption in China has been accompanied by rising incidence of milk allergy. Here we analyzed profiles of specific immunoglobulin E (sIgE) against cow's milk proteins, and assessed their value for milk allergy diagnosis among infants and young children from northern China.
Methods
Sera collected from 48 patients with milk allergy and 27 negative control subjects was analyzed by enzyme-linked immunosorbent assay to measure sIgE to α-lactalbumin (Bos d 4), β-lactoglobulin (Bos d 5), α-casein (Bos d 9), β-casein (Bos d 11), and κ-casein (Bos d 12).
Results
Among milk-allergic individuals, most were sensitized to at least one milk protein; about half were sensitized to Bos d 5, Bos d 9, Bos d 11 and Bos d 12, respectively, while few had positive serum sIgE against Bos d 4. Bos d 12 sIgE had the largest area under curve (AUC) (0.878; 95% CI, 0.800–0.957) and thus showed the best diagnostic performance in discriminating between milk-allergic and non-milk allergic patients, with a sensitivity of 92.6% and specificity of 72.9% using a statistically optimal cut-off value (OD450nm, 0.191). The combinations of Bos d 5?+?Bos d 12 showed an AUC of 0.926, which was larger than for any individual components.
Conclusions
Our results revealed inter-individual variation in the sensitization to different milk allergen component. Bos d 12 sIgE showed best performance in diagnosing milk allergy. Milk allergy diagnostic accuracy was further improved using combinations of milk allergen components by application of ROC curves based on logistic regression.
First Author:
Correspondence:
All Authors:
JunpuLiJiayiZhangCuiyaQiongTiantianSheYingBianShuxiangLinHuiqiangLi
　　創(chuàng)建過(guò)敏性疾病的科研、科普知識(shí)交流平臺(tái)，為過(guò)敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺(tái)。