原標(biāo)題：無癥狀塵螨致敏和塵螨誘導(dǎo)變應(yīng)性鼻炎患者的IgE和IgG4譜
背景：無癥狀致敏的定義為在沒有臨床過敏癥狀的情況下，存在皮膚點(diǎn)刺試驗(yàn)(SPT)陽性和/或血清過敏原特異性IgE陽性。目前，還沒有確切解釋來說明為什么一些過敏原檢測(cè)呈陽性的人沒有出現(xiàn)癥狀。我們本次研究的目的是調(diào)查無癥狀塵螨（HDM）致敏受試者和HDM誘導(dǎo)的變應(yīng)性鼻炎(AR)患者的HDM特異性IgE和IgG4譜。
方法：本研究共納入48例對(duì)HDM致敏的受試者：27例伴哮喘（癥狀組），21例無過敏癥狀（無癥狀組）。6名健康人為對(duì)照組。采集外周血標(biāo)本進(jìn)行浙大迪迅塵螨組分血清IgE和IgG4檢測(cè)和嗜堿性粒細(xì)胞活化試驗(yàn)(BATs)。IgE和IgG4檢測(cè)針對(duì)塵螨組分Der p 1、Der p 2、Der p 7、Der p 10、Der p 21、Der p 23和Der f 1、Der f 2。
結(jié)果：與無癥狀受試者相比，AR患者的SPT風(fēng)團(tuán)直徑更大（7.0比3.0 mm，p < 0.0001），對(duì) Der p的特異性IgE更高（15.50比0.70 KU/L，p < 0.0001）。兩組都表現(xiàn)出對(duì) Der p 1 和 Der p 2 更頻繁的敏感性（p < 0.05）。但兩組間總IgE和特異性IgG4差異無統(tǒng)計(jì)學(xué)意義。在AR患者中觀察到用HDM刺激后的嗜堿性粒細(xì)胞活化反應(yīng)更高（所有p < 0.05）。
結(jié)論：與對(duì)HDM敏感的無癥狀受試者相比，AR患者在SPT，屋塵螨血清特異性IgE，塵螨組分Der p 1和Der p 2水平以及BAT上存在差異。單獨(dú)的塵螨組分特異性IgG4不能區(qū)分無癥狀個(gè)體和AR患者。


原始出處
Int Arch Allergy Immunol
IgE and IgG4 Repertoire in Asymptomatic HDM-Sensitized and HDM-Induced Allergic Rhinitis Patients
DOI: 10.1159/000517824
Abstract:
Introduction: Asymptomatic sensitization is defined as the presence of positive skin prick test (SPT) and/or positive serum allergen-specific IgE in the absence of clinical allergic symptoms. Currently, there is no convincing explanation why some people with positive allergen tests do not show symptoms. We aimed to investigate the house dust mite (HDM)-specific IgE and IgG4 repertoire in asymptomatic HDM-sensitized subjects and HDM-induced allergic rhinitis(AR) patients.
Methods: A total of 48 subjects sensitized to HDM were included in this study: 27 had AR with/without asthma (symptomatic group), and 21 had no allergic symptoms(asymptomatic group). Six healthy individuals served as control group. Peripheral blood samples were collected for serum IgE and IgG4 assay and basophil activation tests(BATs). IgE and IgG4 assay included antibodies to Dermatophagoides(Der) p1, 2, 7, 10, 21, 23, and Der f1, 2.
Results: AR patients had a larger wheal diameter of SPT (7.0 vs. 3.0 mm,p < 0.0001) and a higher specific IgE to Der p (15.50 vs. 0.70 KU/L, p < 0.0001) than asymptomatic subjects. They also showed more frequent sensitization to Der p1 and Der p2 (both p < 0.05). However, the total IgE and specific IgG4 did not differ significantly between the 2 groups. The basophil activation response after being stimulated with HDM was observed to be higher in AR patients (all p < 0.05).
Conclusions: There are differences in SPT, serum-specific IgE to Der p, component allergen Der p1 and Der p2 level and BAT between AR patients and asymptomatic subjects sensitized to HDM. IgG4 alone cannot differentiate asymptomatic individuals from AR patients.
First Author:
Qingxiu Xu
Correspondence:
Rongfei Zhu, zrf13092 @ 163.com
2023-01-13  Article