原標(biāo)題：Alt a 1、真菌烯醇酶、錳依賴型超氧化物歧化酶(MnSOD)在孢菌科過(guò)敏的組份診斷中的作用
　?、俦尘埃涸谶^(guò)去的幾十年里，基因組學(xué)和蛋白質(zhì)組學(xué)對(duì)目前有關(guān)個(gè)性化過(guò)敏原組份的知識(shí)及其在診斷IgE介導(dǎo)的過(guò)敏方面的潛在應(yīng)用做出了貢獻(xiàn)。最近的研究表明，Alt a1被認(rèn)為是孢子菌屬的相關(guān)過(guò)敏原，烯醇化酶是真菌交叉反應(yīng)的主要過(guò)敏原。然而，這些過(guò)敏原作為診斷變應(yīng)原過(guò)敏的工具的真正用途仍不清楚。②目的：展示現(xiàn)有真菌過(guò)敏原系列組份的價(jià)值，以及建立準(zhǔn)確的霉菌過(guò)敏原陣列以診斷對(duì)孢菌科過(guò)敏的必要性。③方法：在30位鏈格孢屬過(guò)敏患者和100位捐獻(xiàn)者的血液中，用ImmunoCAP?系統(tǒng)檢測(cè)單個(gè)真菌過(guò)敏原和真菌過(guò)敏原提取物的特異性IgE。交叉反應(yīng)研究采用單個(gè)過(guò)敏原和過(guò)敏原提取物的熒光酶免疫法(FEIA)和FEIA抑制法。用雙向電泳結(jié)合MALDI-TOF分析的方法識(shí)別新的過(guò)敏原分子。④結(jié)果：所有過(guò)敏患者對(duì)不同分類學(xué)的幾種霉菌均有陽(yáng)性的特異性IgE反應(yīng)。經(jīng)典和分子診斷顯示23%的患者有多種致敏。目前市面上的真菌過(guò)敏原陣列還不足以建立準(zhǔn)確的診斷。鏈格孢屬或Alt a1與彎曲菌或枝孢桿菌之間存在出乎意料的相關(guān)性，這激發(fā)了對(duì)更準(zhǔn)確過(guò)敏原組份系列的研究。與Asp f6同源的錳依賴型超氧化物歧化酶(MnSOD)被鑒定為一種新的鏈格孢霉IgE結(jié)合分子。⑤結(jié)論和臨床相關(guān)： Alt a1是對(duì)孢菌科過(guò)敏的標(biāo)記物，不包括彎菌屬。錳依賴型超氧化物歧化酶(MnSOD)可以在對(duì)Alt a 1不敏感的患者中解釋6.6%的鏈格孢屬過(guò)敏，在診斷孢菌科過(guò)敏時(shí)應(yīng)與Alt a1和真菌烯醇化酶一起納入分子陣列中。
延伸閱讀
Allergy                                             
[IF:6.05]
Volume41, Issue3  March  2011  Pages 443-451
 Diagnostic value of Alt a 1, fungal enolase and manganese‐dependent superoxide dismutase in the component‐resolved diagnosis of allergy to pleosporaceae
doi.org/10.1111/j.1365-2222.2010.03671.x
Abstract:
Summary
 Background Over the last decades, genomics and proteomics have contributed to the current knowledge of individualized allergenic components and their potential use in the diagnosis of IgE‐mediated allergies. Recent investigations have demonstrated that Alt a 1 should be considered as a relevant allergen of the Pleosporaceae group and that enolase is the main allergen involved in the cross‐reactivity to fungi. However, the real utility of these allergens as tools for the diagnosis of allergy to Alternaria is still unclear.
Objective To demonstrate the current value of the available fungal allergen panel and the need to build an accurate mould allergen array for the diagnosis of allergy to Pleosporaceae.
Methods Specific IgEs to individual mould allergens and allergenic mould extracts were evaluated using the ImmunoCAP? system in 30 patients allergic to Alternaria and in 100 blood donors. Cross‐reactivity studies were performed by Fluoro Enzyme ImmunoAssay (FEIA) and FEIA inhibition using individual allergens and allergenic extracts. Two‐dimensional electrophoresis associated with a MALDI‐TOF analysis was carried out to identify new allergen molecules.
Results
All allergic patients had positive specific IgE responses to several moulds from different taxonomical families. Classic and molecular diagnosis demonstrated that 23% of patients had multi‐sensitization. The current commercially available fungal allergen array was not sufficient to establish an accurate diagnosis. Unexpected correlations between Alternaria or Alt a 1 and Curvularia or Cladosporium stimulated the investigation of a more accurate allergen panel. A manganese‐dependent superoxide dismutase (MnSOD) homologous to Asp f 6 was identified as a new IgE‐binding molecule from Alternaria alternata.
Conclusions and Clinical Relevance Alt a 1 is the marker for allergy to Pleosporaceae, not including Curvularia. MnSOD can explain 6.6% of allergy to Alternaria without Alt a 1 sensitization and should be included together with Alt a 1 and fungal enolase in the molecular array for the diagnosis of allergy to Pleosporaceae
All Author:
I. Postigo  A. Gutiérrez‐Rodríguez J. Fernández J. A. Guisantes E. Su?én J. Martínez
　　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)。