背景：過敏原組分檢測(cè)(CRD)允許識(shí)別單分子過敏原組分，并構(gòu)成了許多過敏單位的常規(guī)做法。然而，皮膚點(diǎn)刺試驗(yàn)(SPT)仍然是許多耳鼻喉科的首選技術(shù)，但同時(shí)也增加了在呼吸道過敏患者中使用不充分的免疫療法的風(fēng)險(xiǎn)。本研究旨在比較呼吸道過敏患者SPT和CRD測(cè)得的致敏譜，探討致敏與呼吸道疾病類型和嚴(yán)重程度之間的關(guān)系。
方法：本研究為因呼吸過敏癥狀入院的耳鼻喉科患者的橫斷面、多中心研究。SPT檢測(cè)不同室內(nèi)塵螨、花粉和霉菌的提取物，CRD檢測(cè)其對(duì)相應(yīng)抗原的IgE。
結(jié)果：分析包括101名患者。SPT獲得的致敏譜與CRD的致敏譜一致性較低，特別是對(duì)塵螨和花粉（車前草、油橄欖和柏樹）。雖然SPT在致敏和呼吸系統(tǒng)疾病的類型/嚴(yán)重程度之間沒有顯示出任何顯著的關(guān)系，但CRD允許將Der p 1，Der f 1和Lep d 2致敏與哮喘以及Der p 2，Der f 2和Lep d 2與更嚴(yán)重的過敏性鼻炎相關(guān)聯(lián)。
結(jié)論：與SPT相比，CRD能夠描述更準(zhǔn)確的致敏譜，并能夠識(shí)別癥狀和特異性抗原之間的關(guān)聯(lián)。在耳鼻喉科環(huán)境中常規(guī)使用CRD可能有助于呼吸過敏患者的管理。
延伸閱讀
Clinical and Molecular Allergy 
Sensitization profle inpatients with respiratory allergic diseases: diferences between conventional and molecular diagnosis (a cross?sectional study)
DOI: org/10.1186/s12948-019-0112-4
Abstract:
Background: Component-resolved diagnosis (CRD) allows to identify single molecular allergen components, and constitutes a routine practice in many allergy units. However, skin prick test (SPT) remains the technique of choice in many otorhinolaryngology departments, thus increasing the risk of using inadequate immunotherapies in patients with respiratory allergies. This study aimed to compare sensitization profles determined by SPT and CRD in patients with respiratory allergy, and to explore the relationship between sensitization and type and severity of the respiratory disease.
Methods: Cross-sectional, multicenter study of patients admitted to the Otorhinolaryngology Department due to symptoms of respiratory allergy. Extracts from various house dust mites, pollens, and molds were tested by SPT, whereas IgE against the corresponding antigens were measured by CRD.
Results: The analysis included 101 patients. The sensitization profle obtained by SPT had low agreement with that of CRD, particularly to dust mite allergens (Dermatophagoides sp.) and pollens (Plantago lanceolata, Olea europaea, and Cupressus sempervirens). While SPT did not show any signifcant relationship between sensitization and type/severity of the respiratory disease, CRD allowed to associate Der p 1, Der f 1 and Lep d 2 sensitizations with asthma, and Der p 2, Der f 2 and Lep d 2 sensitizations with more severe symptoms of allergic rhinitis.
Conclusion: Compared with SPT, CRD enables to describe a more accurate sensitization profle and to identify associations between symptoms and specifc antigens. The routine use of CRD in an otorhinolaryngology setting may beneft the management of patients with respiratory allergy.
First Author:
Guillermo Til—Pérez
Corresponding author
Manuel David TomásBarberán
Correspondence:
Department of Otorhinolaryngology, Hospital Universitario Son Espases, Palma de Mallorca, Spain