原標題:螨蟲過敏分子組份診斷的臨床價值
——來自浙大迪迅
?、僭隍x過敏的患者中,用天然過敏原提取物進行IgE抗體檢測并不能揭示致敏分子的性質(zhì)。屋塵螨(HDM)和倉儲螨(SM)的致敏作用較為常見。本研究的目的是確定致敏的分子模式是否有助于優(yōu)化對這些病人的診斷。②101名在我們門診就診的對螨蟲敏感的鼻結(jié)膜炎及/或哮喘病人被納入本研究。對所有病人分別進行屋塵螨和害嗜鱗螨提取液的皮膚點刺試(SPT, ALK-Abelló)和特異性IgE (ImmunoCAP)。同時,在Advia Centaur平臺上,檢測包括Der p1、Der p2、Der f1、Der f2、Lep d2和Der p10(螨蟲原肌球蛋白)在內(nèi)的過敏原組分特異性IgE。③所有受試者對屋塵螨SPT陽性,99%的受試者的屋塵螨特異性IgE陽性。這些患者對Der p1的敏感性為81.2%,對Der p2的敏感性為93.1%。SPT和特異性IgE對害嗜鱗螨的敏感性分別為84.2%和85.1%,對Lep d2的敏感性僅為42.6%。只有2%的患者對derp10呈陽性反應(yīng)。④在螨蟲過敏中,分子診斷并不總是與天然提取物的診斷一致,尤其是在倉儲螨中。我們認為重要的是了解致敏的分子組份,以便為患者提供更準確的診斷和病因治療。
延伸閱讀
JACI:
[IF:13.1]
Clinical Usefulness Of Diagnosis By Molecular Components In Mite Allergy
DOI: https://doi.org/10.1016/j.jaci.2011.12.661
Abstract:
Rationale
In patients allergic to mites IgE antibody test with a natural allergen extract does not reveal the nature of the sensitizing molecules. Polisensitization to House Dust Mites (HDM) and Storage Mites (SM) is frequently observed. The aim of this study is to define whether determination of molecular patterns of sensitization is useful for optimizing the diagnosis of these patients.
Methods
101 patients attending our outpatient clinic suffering rhinoconjunctivitis and/or asthma sensitized to mites were included. Skin prick test (SPT,) and specific IgE (ImmunoCAP) to the HDM Dermatophaghoides pteronyssinus and to the SM Lepidoglyphus destructor were done. In parallel, IgE to a panel of allergen components including Der p1, Der p2, Der f1, Der f2, Lep d2 and Der p10 (mite tropomyosin) were performed in the Advia Centaur platform.
Results
All subjects showed positive SPT and 99% positive IgE to D. pteronyssinus. In these patients 81.2% sensitization to Der p1 and 93.1% to Der p2 was found. SPT and specific IgE to L. destructor was positive in 84.2% and 85.1% respectively, although only 42.6% had sensitization to Lep d2. Positivity to Derp 10 was found in only 2% of patients.
Conclusions
In mite allergy the molecular diagnosis does not always coincide with the diagnosis performed with natural extracts, especially in SM. We consider important to know the molecular components responsible for the sensitization, in order to provide a more accurate diagnosis and etiological treatment to our patients.
All Author:
F. Rodriguez Fernandez, M. Lopez Hoyos, P. Munoz Cacho, C. Barbeitio, G. Perdomo Gutierrez, A. Galan Nieto, M. Arina Sanche
2018-12-24 Article
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。