原標(biāo)題：出生后20年內(nèi)，IgE對屋塵螨變應(yīng)原反應(yīng)性的變化及其預(yù)測價值
　?、買gE對屋塵螨中許多過敏原分子的反應(yīng)性的演化至今還不清楚②我們試圖描述從出生到成年過程中IgE對12種屋塵螨分子的應(yīng)答的演化模式，并研究它們的決定因素和臨床相關(guān)性。③我們在德國出生隊(duì)列的多中心過敏研究中對722名參與者的血清和臨床資料進(jìn)行了研究，該研究始于1990年。與螨蟲過敏相關(guān)的現(xiàn)有的過敏性鼻炎和哮喘的診斷是基于1歲-13歲和1歲-20歲過程中每年一次的隨訪。在1、2、3、5、6、7、10、13、20歲時，IgE對屋塵螨提取物及12種過敏分子的反應(yīng)性分別用 ImmunoCAP和微陣列的方法檢測，在6個月和18個月時的螨蟲暴露，通過檢測室內(nèi)灰塵中的Der p 1重量/重量濃度來評估。④722名參與者中有191名(26.5%)曾有對屋塵螨提取物的IgE(≥0.35 kUA/L)。20歲時，他們的IgE對螨蟲組份識別率最高的是Der p 2、Der p1和Der p 23 (A組分子;陽性率為>40%)，其次為Der p5、Der p7、Der p4、Der p21 (B組分子;陽性率15% to 30%）和Der p 11、Der p 18、克隆16、Der p14和Der p15 (C組分子;陽性率< 10%)。IgE敏化幾乎總是從A組開始，然后依次擴(kuò)展到B組，最后擴(kuò)展到C組。早期IgE敏化開始、父母花粉熱和較高的螨暴露與更廣泛的多分子IgE敏化模式有關(guān)。達(dá)到最廣泛IgE敏化階段(即ABC)的參與者患螨蟲相關(guān)AR和哮喘的風(fēng)險明顯高于未敏化的參與者。5歲或更小的時候IgE對Der p 1或Der p 23的反應(yīng)性對學(xué)齡哮喘有預(yù)測價值。⑤父母花粉熱和早期的屋塵螨變應(yīng)原暴露可促進(jìn)IgE對若干屋塵螨過敏原分子的多重敏化，進(jìn)而預(yù)測當(dāng)前與屋塵螨相關(guān)的AR和當(dāng)前/未來的哮喘。這些結(jié)果可能會對依據(jù)IgE敏感性的演化預(yù)測和預(yù)防螨蟲相關(guān)AR和哮喘有所啟發(fā)。
延伸閱讀
JACI
Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life
DOI: https://doi.org/10.1016/j.jaci.2016.08.014
Background
The evolution of the IgE response to the numerous allergen molecules of Dermatophagoides pteronyssinus is still unknown.
Objectives
We sought to characterize the evolutionary patterns of the IgE response to 12 molecules of D pteronyssinus from birth to adulthood and to investigate their determinants and clinical relevance.
Methods
We investigated the clinical data and sera of 722 participants in the German Multicenter Allergy Study, a birth cohort started in 1990. Diagnoses of current allergic rhinitis (AR) related to mite allergy and asthma were based on yearly interviews at the ages of 1 to 13 years and 20 years. IgE to the extract and 12 molecules of D pteronyssinus were tested by means of ImmunoCAP and microarray technology, respectively, in sera collected at ages 1, 2, 3, 5, 6, 7, 10, 13, and 20 years. Exposure to mites at age 6 and 18 months was assessed by measuring Der p 1 weight/weight concentration in house dust.
Results
One hundred ninety-one (26.5%) of 722 participants ever had IgE to D pteronyssinus extract (≥0.35 kUA/L). At age 20 years, their IgE recognized most frequently Der p 2, Der p 1, and Der p 23 (group A molecules; prevalence, >40%), followed by Der p 5, Der p 7, Der p 4, and Der p 21 (group B molecules; prevalence, 15% to 30%) and Der p 11, Der p 18, clone 16, Der p 14, and Der p 15 (group C molecules; prevalence, <10%). IgE sensitization started almost invariably with group A molecules and expanded sequentially first to group B and finally to group C molecules. Early IgE sensitization onset, parental hay fever, and higher exposure to mites were associated with a broader polymolecular IgE sensitization pattern. Participants reaching the broadest IgE sensitization stage (ie, ABC) had significantly higher risk of mite-related AR and asthma than unsensitized participants. IgE to Der p 1 or Der p 23 at age 5 years or less predicted asthma at school age.
Conclusions
Parental hay fever and early exposure to D pteronyssinus allergens promote IgE polysensitization to several D pteronyssinus molecules, which in turn predicts current mite-related AR and current/future asthma. These results might inspire predictive algorithms and prevention strategies against the progression of IgE sensitization to mites toward AR and asthma.
All Author:
Daniela Posa Serena Perna Yvonne Resch Christian Lupinek Valentina Panetta Stephanie Hofmaier Alexander Rohrbach Laura Hatzler Linus Grabenhenrich Olympia Tsilochristou Kuan-Wei Chen Carl-Peter Bauer Ute Hoffman Johannes Forster Fred Zepp Antje Schuster Ulrich Wahn Thomas Keil Susanne Lau Susanne Vrtala Rudolf Valenta Paolo Maria Matricardi
　　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。