Th17细胞在过敏性紫癜患儿外周血中的分布及意义北大核心CSCD

目的探讨过敏性紫癜(HSP)患儿外周血单个核细胞(PBMCs)中Th17细胞比例及血清IL-17水平变化的临床意义。方法选择HSP患儿30例和正常对照儿童20例,应用流式细胞分析法检测外周血Th17细胞的比例,应用ELISA法检测血清IL-17水平,分析和比较HSP患儿和对照儿童的检测结果。结果 HSP患儿PBMCs中Th17细胞比例为(2.14±0.90)%,显著高于对照组的(0.84±0.41)%,差异有统计学意义(P<0.05);HSP患儿血清IL-17水平为(38.36±13.44)pg/ml,高于对照组的(10.59±4.17)pg/ml,差异有统计学意义(P<0.05)。结论 HSP患儿PBMC中Th17细胞比例明显增高,提示Th17细胞可能参与了HSP的发病过程。     

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目的探讨支气管哮喘患儿外周血中辅助T细胞(Th)17细胞和CD4+CD25+调节性T细胞(Treg)的变化与儿童哮喘病情的相关性。方法收集2009年月5月至2010年4月于郑州大学第一附属医院就诊的患儿,均为首次确诊哮喘或规范吸入激素停用>3个月后复发及近1个月内无明显感染者。采用流式细胞仪测定患儿外周血中Th17细胞及CD4+CD25+Treg比例的变化。结果 Th17细胞在哮喘急性期组(2.24%±1.02%)较哮喘缓解期组(1.65%±0.38%)及健康儿童组(1.02%±0.28%)均显著增高(P<0.05),哮喘缓解期组(1.65%±0.38%)和健康儿童组(1.02%±0.28%)无明显差别,CD4+CD25+Treg细胞比例在3组儿童间差异均有统计学意义(F=45.604,P<0.05),与健康儿童组(7.11%±0.89%)相比,哮喘缓解期组(6.05%±0.87%)和哮喘急性期组(5.37%±0.80%)的比例明显下降,而哮喘急性期组较健康儿童组下降。哮喘急性期组轻、中、重度3组之间差异同样有统计学意义。Th17细胞与哮喘患儿病情呈正相关(r=0.649,P<0.05),而CD4+CD25+...     

血浆白三烯B4与儿童过敏性紫癜免疫机制的相关性

目的 探讨血浆白三烯B4(LTB4)在过敏性紫癜(HSP)患儿免疫发病机制中的作用.方法 2009年5月-2010年3月河北医科大学第二医院儿科住院HSP患儿55例(HSP组),同时取健康同龄儿童20例作为健康对照组.采用ELISA法检测各组血浆LTB4水平,流式细胞术检测各组外周血CD4+CD25+调节性T淋巴细胞及Th17细胞比例,同时观察LTB4水平与二者的相关性.应用SPSS 13.0软件进行统计学分析.结果 1.HSP患儿血浆LTB4[(63.5±20.8) ng·L-1]与健康对照组[(34.5±10.0) ng·L-1]比较明显升高(P＜0.01);2.CD4+CD25+调节性T 淋巴细胞[(3.81±1.10)%]与健康对照组[(4.45±0.90)%]比较明显降低(P＜0.05);3.Th17细胞[(1.80±0.66)%]与健康对照组[(0.52±0.24)%] 比较明显升高(P＜0.01);4.血浆LTB4水平与CD4+CD25+调节性T 淋巴细胞呈显著负相关(r=-0.67,P＜0.05),与Th17细胞呈显著正相关(r=0.57,P＜0.05).结论 LTB4可能参与HSP患儿细胞免疫功能紊乱.     

Th17细胞在过敏性紫癜患儿外周血中的分布及意义

目的探讨过敏性紫癜(HSP)患儿外周血单个核细胞(PBMCs)中Th17细胞比例及血清IL-17水平变化的临床意义。方法选择HSP患儿30例和正常对照儿童20例,应用流式细胞分析法检测外周血Th17细胞的比例,应用ELISA法检测血清IL-17水平,分析和比较HSP患儿和对照儿童的检测结果。结果 HSP患儿PBMCs中Th17细胞比例为(2.14±0.90)%,显著高于对照组的(0.84±0.41)%,差异有统计学意义(P0.05);HSP患儿血清IL-17水平为(38.36±13.44)pg/ml,高于对照组的(10.59±4.17)pg/ml,差异有统计学意义(P0.05)。结论 HSP患儿PBMC中Th17细胞比例明显增高,提示Th17细胞可能参与了HSP的发病过程。     

哮喘儿童细胞因子信号转导抑制因子mRNA表达与Th1/Th2的关系

目的：细胞因子信号转导抑制因子(SOCS)对JAK-STAT途径的细胞因子如白介素、干扰素等的调节起重要作用,目前SOCS与哮喘的关系仍在研究中。本研究观察SOCS1和SOCS3 mRNA在哮喘儿童外周血单个核细胞（PBMC）中的表达水平与CD4+ T细胞IFN-γ/IL-4平衡及特异性IgE（sIgE）的关系。方法：采集44例4~14岁过敏性哮喘患儿及30例健康儿童PBMC,分别用流式细胞仪分析CD4+ T细胞IFN-γ/IL-4比值,另提取总RNA,采用SYBR Green I逆转录荧光定量PCR的方法检测每组SOCS1和SOCS3 mRNA的表达。结果：哮喘组患儿外周血IFN-γ阳性的CD4+T细胞百分比［（15.7±2.0）%］及IFN-γ/IL-4比值（3.4±1.5）均低于对照组［分别为（19.1±2.7)%、4.8±2.9］;而SOCS1 mRNA（⊿Ct值11.1±1.9）表达显著高于对照组（⊿Ct值12.6±2.8）。两组儿童SOCS1 mRNA表达均与外周血分泌IFN-γ的CD4+ T细胞百分比呈负相关（P<0.05）。SOCS1和SOCS3与sIgE均无相关性。结论：SOCS1 mRNA在哮喘组患儿外周血中高表达,并与Th2占优势的免疫失衡有关。     

Th17细胞及其特异性转录因子RORγt在儿童过敏性紫癜发病机制中的作用

目的探讨Th17细胞及其特异性转录因子RORγt在儿童过敏性紫癜(HSP)发病机制中的作用,为儿童HSP的治疗从调控Th17细胞作为切入点提供一条新思路。方法研究对象为2012年2月-2013年3月在我院儿科诊治的初次发病HSP急性期患儿40例,以及同期来我院体检的健康儿童40例,采用SYBR GreenⅠ实时荧光定量PCR技术测定外周血单个核细胞中RORγt mRNA的表达水平;用流式细胞术测定外周血T淋巴细胞中Th17细胞的表达;用双抗夹心ABCELISA技术测定血清IL-17A、TGF-β_1、IL-6浓度。结果 HSP组的Th17细胞(2.75%±0.60%)和RORγt mRNA(1.11±0.51)明显高于对照组的Th17细胞(1.41%±0.29%)和RORγt mRNA(0.65±0.24)(P0.01);HSP组血清IL-17A(40.40±11.81 pg/mL)、IL-6(75.38±27.19 pg/mL)、TGF-β_1(309.41±81.03 pg/mL)与对照组IL-17A(20.32±10.70 pg/mL)、IL-6(25.16±8.31 pg/mL)、TGF-β_1(236.34±66.01 pg/mL)相比明显升高(P0.01);在HSP组Th17细胞表达与RORγt mRNA、IL-17A、IL-6表达呈正相关,相关系数分别为0.887,0.938,0.934(P0.01)。结论急性期HSP患儿存在Th17细胞、RORγt mRNA及IL-17A表达水平升高,提示Th17细胞、RORγt及IL-17A均参与了HSP的发病机制;急性期HSP患儿存在血清TGF-β_1、IL-6水平增高,且Th17细胞表达水平与IL-6表达呈正相关,提示TGF-β_1、IL-6可能通过对Th17细胞的调节参与HSP发病机制。     

Th17/Treg在幼年特发性关节炎合并特应质中的研究

目的探讨特应质对幼年特发性关节炎(JIA)患儿病情活动的影响,以及Th 17/Treg失衡的作用。方法入选47例JIA合并特应质(特应质组)、64例单纯JIA(单纯组)及20例健康对照儿童(对照组)。ELISA方法检测血清IL-1β、IL-6、IL-17水平,流式细胞术检测外周血Th 17、Treg细胞在淋巴细胞中的比例,RT-qPCR检测外周血单个核细胞IL-17 mRNA、Foxp 3 mRNA表达,比较三组间的差异;同时比较两组JIA患儿疾病活动指标的差异。结果对照组、单纯组和特应质组之间,血清IL-1β、IL-6、IL-17水平,Th17、Treg细胞在淋巴细胞中的比例以及IL-17 mRNA、Foxp3 mRNA表达水平的差异均有统计学意义(P0.01)。特应质组与单纯组血清IL-1β、IL-6、IL-17水平均高于对照组,特应质组高于单纯组,差异均有统计学意义(P0.05)。特应质组Th17细胞在淋巴细胞中的比例以及IL-17mRNA表达水平最高,对照组最低。特应质组Treg细胞在淋巴细胞中的比例最低,对照组最高。特应质组血小板计数、医师对疾病总体评估(PGA)、患者/家长对疾病总体评估(PGE)、患儿健康评估问卷调查(CHAQ)、活动关节炎数目、活动受限关节数目、JADAS27评分均明显高于单纯组,差异有统计学意义(P0.05)。结论 JIA合并特应质患儿的疾病活动性更高,可能与IL-1β、IL-6水平升高、Th17/Treg平衡更偏向Th17方向发展有关。     

Th2抑制剂在儿童过敏免疫性疾病中的应用

基于Th2细胞因子在过敏性疾病中的作用，Th2抑制剂已被认为可应用于儿童过敏性哮喘和变应性鼻炎针对靶点的药物治疗。甲磺司特是一种新型选择性Th2细胞因子抑制剂，能选择性抑制Th细胞、减少炎症介质的产生，改善过敏性疾病的症状。在日本制定的儿童支气管哮喘指南与变应性鼻炎指南中均推荐可应用甲磺司特。甲磺司特是我国首个批准上市的Th2细胞因子抑制剂，2020年成人支气管哮喘防治指南推荐可应用甲磺司特治疗支气管哮喘，但该药在我国的应用尚处于起步阶段。该文就Th2抑制剂甲磺司特在儿童过敏免疫性疾病中的应用作一综述，以促进我国儿童Th2抑制剂的规范使用。     

再生障碍性贫血患儿外周血Tre g／Th 17细胞失衡的研究

目的：探讨CD4＋CD25＋调节性T细胞（Treg）/Th17细胞失衡在儿童再生障碍性贫血（AA）发病中的意义。方法采用流式细胞仪（FCM）检测AA患儿和健康对照组儿童外周血Treg细胞和Th17细胞的比例,酶联免疫吸附法（ELISA）检测血浆中IL-17和IL-6的水平。结果 AA患儿外周血Th17细胞比例（1.45±0.28）％显著高于同龄对照组（0.45±0.10）％（P＜0.01）,而Treg细胞比例（4.05±1.07）％及 Treg/Th17细胞比值（2.89±0.88）明显低于同龄对照组儿童（6.96±0.79）％、（15.77±2.77）（P＜0.01）。AA患儿血浆中IL-17、IL-6水平分别为（185.96±40.42）、（20.78±5.49）pg/mL,显著高于同龄对照组（120.47±18.39）、（10.44±2.51）pg/mL （P＜0.01）,且IL-17和IL-6水平均与Th17细胞比例呈正相关（r＝0.67,P＜0.01;r＝0.57,P＜0.01）,而Treg细胞比例与IL-6水平呈负相关（r＝-0.39,P＜0.05）。结论 AA患儿Treg细胞比例的减低和Th17细胞比例的增加所致的Treg/Th17细胞失衡,可能在儿童再障发病中起重要作用,IL-6高表达可能是导致Tre g/Th 17细胞失衡的原因之一。     

Th17/Treg细胞比例失衡在儿童原发性免疫性血小板减少症中的意义

目的 探讨Th17/Treg 细胞比例失衡在儿童原发性免疫性血小板减少症(ITP)发病及治疗中的意义。方法 选取2015 年5 月至2015 年8 月确诊为ITP 的32 例患儿作为ITP 组,同期选取22 例健康儿童作为健康对照组,采用流式细胞术分别检测初诊ITP 患儿、丙种球蛋白治疗后的ITP 患儿和健康对照组儿童外周血Th17、Treg 细胞的比例。结果 ITP 患儿治疗前外周血Th17 占CD4⁺T 细胞的比例、Th17/Treg 细胞比值均显著高于治疗后及健康对照组儿童(P<0.05),治疗前Treg 细胞占CD4⁺T 细胞的比例显著低于治疗后及健康对照组儿童(P<0.05);32 例ITP 患儿经治疗后,20 例完全反应,4 例有效,8 例无效,完全反应患儿外周血Th17细胞占CD4⁺T 细胞比例、Th17/Treg 细胞比值显著低于无效患儿(P<0.05)。结论 儿童ITP 中存在Th17/Treg细胞比例失衡,丙种球蛋白可通过调节Th17/Treg 细胞比例变化进而改变患儿细胞免疫功能,治疗过程中检测该比值变化可能对疾病的疗效有一定的预测作用。     

High cord blood levels of the T-helper 2-associated chemokines CCL17 and CCL22 precede allergy development during the first 6 years of life

Exposure to a strong T-helper 2 (Th2)-like environment during fetal development may promote allergy development. Increased cord blood (CB) levels of the Th2-associated chemokine CCL22 were associated with allergy development during the first 2 y of life. The aim of the present study was to determine whether CB Th1- and Th2-associated chemokine levels are associated with allergy development during the first 6 y of life, allowing assessment of respiratory allergic symptoms usually developing in this period. The CB levels of cytokines, chemokines, and total IgE were determined in 56 children of 20 women with allergic symptoms and 36 women without allergic symptoms. Total IgE and allergen-specific IgE antibody levels were quantified at 6, 12, 24 mo, and 6 y of age. Increased CB CCL22 levels were associated with development of allergic sensitization and asthma and increased CCL17 levels with development of allergic symptoms, including asthma. Sensitized children with allergic symptoms showed higher CB CCL17 and CCL22 levels and higher ratios between these Th2-associated chemokines and the Th1-associated chemokine CXCL10 than nonsensitized children without allergic symptoms. A pronounced Th2 deviation at birth, reflected by increased CB CCL17 and CCL22 levels, and increased CCL22/CXCL10 and CCL17/CXCL10 ratios might promote allergy development later in life.     

Measurement of Ara h 1-, 2-, and 3-specific IgE antibodies is useful in diagnosis of peanut allergy in Japanese children

To cite this article: Ebisawa M, Movérare R, Sato S, Maruyama N, Borres MP, Komata T. Measurement of Ara h 1-, 2-, and 3-specific IgE antibodies is useful in diagnosis of peanut allergy in Japanese children. Pediatr Allergy Immunol 2012: 23: 573-581. ABSTRACT: Background: Food challenges are time-consuming, expensive, and not always possible to perform. Therefore, new tools to diagnose food allergy are desired. The aim was to evaluate IgE antibodies to peanut allergens in the diagnosis of peanut allergy in Japanese children using ImmunoCAP(?) and IgE immunoblotting. Methods: The study included 2-13-yr-old consecutive patients (n?=?57) referred to our specialist clinic for investigation of current peanut allergy using food challenge. All children had a previous doctor's diagnosis of peanut allergy and were on elimination diet. Serum samples were analyzed for IgE reactivity to peanut, recombinant (r) Ara h 1, 2, 3, 5, 8, and 9. IgE immunoblotting (n?=?23) was performed using extracts from raw and roasted peanut. Results: Twenty-six of the children failed (allergic group), and 31 passed the peanut challenge (tolerant group). The rAra h 2 ImmunoCAP test was superior in its ability to differentiate between children in the allergic and tolerant groups with a sensitivity and specificity of 88% and 84%, respectively (cutoff, 0.35?kU(A) /l). The combination of rAra h 1, 2, and 3 resulted in a higher specificity (94%) when IgE to all of them was the criteria for positivity. ImmunoCAP generally showed a good agreement with immunoblotting using both raw and roasted peanut for IgE reactivity to Ara h 1, 2, and 3. Conclusions: Measurement of IgE antibodies to rAra h 1, 2, and 3 is useful in the diagnosis of peanut allergy and in the investigation of reactions to raw and roasted peanut.     

儿童哮喘急性发作时血清C-反应蛋白浓度变化及临床意义

目的探讨血清C-反应蛋白(CRP)在儿童哮喘急性发作时的浓度变化及其临床意义。方法检测182例支气管哮喘急性发作患儿和50例非感染患儿的血清CRP和总IgE浓度,根据发病诱因,将哮喘急性发作患儿分为过敏诱发组、病毒感染诱发组和细菌感染诱发组,检测哮喘患儿血清过敏原特异性IgE,分析各组患儿及正常儿童的血清CRP变化。结果在哮喘急性发作时,细菌感染诱发组患儿的血清CRP水平最高(19.55±17.61)mg/L,过敏诱发组(5.45±4.32)mg/L、病毒感染诱发组(8.61±8.03)mg/L轻度升高,与正常对照组(1.61±1.25)mg/L相比,差异均有统计学意义(P均<0.001)。正常对照组、过敏诱发组、病毒感染诱发组、细菌感染诱发组儿童所对应的血清CRP水平分别为0～2 mg/L、2～10 mg/L、5～16 mg/L、≥16 mg/L,当CRP≥16 mg/L时应考虑发作诱因为细菌感染的可能性大。血清CRP、总IgE及食物呼吸过敏原之间没有显著性关系。结论过敏诱发、病毒感染诱发哮喘急性发作血清CRP浓度范围一般为2～10 mg/L、5～16 mg/L,哮喘急性发作时血清CRP≥16 mg/L时注意细菌感染及合并肺炎。     

Development of specific immunoglobulin E in coughing toddlers: A medical records review of symptoms in general practice

The aim of this study was to study whether young children, originally immunoglobulin E (IgE) negative and who became sensitized to specific inhalation allergens, presented more frequently to their general practi‐tioner (GP) with other allergy‐ and asthma‐related symptoms than children who remained IgE negative. It was also investigated whether asthma was diagnosed more often in children who developed IgE to inhalant allergens. Coughing children, 1–5 years of age, visiting the participating GPs, were tested for IgE antibodies to mites, dogs, and cats by using radioallergosorbent testing (RAST). All IgE‐negative (RAST < 0.2 IU/ml) children were re‐tested after 2 years. The medical records of 162 children were reviewed on asthma‐ and allergy‐related symptoms and on prescribed medication. After 30 months, 27 of the 162 children (17%) had become IgE positive for one or more allergens. Most children (93%) had visited their GP for treatment of respiratory symptoms during this period. However, the children who had become IgE positive had visited their GP more often than the children who remained IgE negative. Differences in visits were seen for: shortness of breath (52% IgE‐positive vs. 19% IgE‐negative children, respectively), wheeze (37% vs. 17%), allergic rhinitis (33% vs. 16%), and pneumonia (22% vs. 8%), but not for coughing (89% vs. 88%). The IgE‐positive children were more frequently diagnosed by their GP as having asthma (48%) than were the IgE‐negative children (23%). In a multivariate analysis, indicators of becoming IgE positive were: a visit for shortness of breath (odds ratio [OR] = 6.9; 95% confidence interval [CI] = 2.1–23.1) and two or more visits for wheeze (OR = 6.0; 95% CI = 1.9–19.2), adjusted for breast‐feeding, age, and asthma or allergy in the family. The positive predictive value (PPV) of being IgE positive with a diagnosis of asthma was 90% (whereas the negative predictive value was 48.0%) for a child attending their GP for treatment of wheeze. For recurrent coughing (six or more visits) and shortness of breath, the PPVs were 73% and 71%, respectively. The development of sensitization to common inhalant allergens is associated with specific allergy and asthma‐related symptoms in young children. IgE‐positive children were more frequently diagnosed as having asthma by their GP. This implies that in general practice it is possible to detect children at high risk for developing allergic asthma early in life by their respiratory symptoms and by subsequent testing for specific IgE to inhalant allergens.     

Different serum interleukin‐12 and sCD30 levels in food‐ and pollen‐sensitized children

It has been proposed that a down-regulation of interleukin (IL)-12 and interferon (IFN)-γ might be related to susceptibility to allergy in early life. The aim of this study was to assess serum IL-12 levels in food-sensitized and pollen-sensitized children and to compare these with another activation marker, sCD30. Twenty children with pollen allergy and 22 food-sensitized children were included. The diagnosis of immunoglobulin (Ig)-E-mediated allergy, suggested by clinical symptoms, was based on skin-prick tests, serum IgE antibodies and total IgE levels. Samples from 24 non-allergic children were used as controls. IL-12 and sCD30 levels were measured by ELISA. It was found that pollen-sensitized patients had normal IL-12 and higher sCD30 levels than controls (114 vs. 63 U/ml, p = 0.028), but, surprisingly, food-sensitized infants showed normal sCD30 and increased serum IL-12 levels (323 vs. 118 pg/ml, p = 0.0001). No differences were found in patients suffering from asthma or allergic dermatitis. Levels of sCD30 and IL-12 determined in May showed a strong correlation with those obtained in November. Interleukin-12 and IgE levels had an inverse correlation (r = –0.494, p = 0.0001) whereas no correlation was found between sCD30 and IgE. Age had a strong negative influence on IL-12 levels in allergic (Z = 4.834, p < 0.0005) and in normal children (Z = 3.00, p < 0.002); by contrast, sCD30 levels were not significantly age-dependent. When IL-12 levels from the food-allergy group were compared with those from normal controls younger than 4 years of age, the difference remained significant (p = 0.001), ruling out an age-bias. The conclusions made in this study were that serum IL-12 and sCD30 showed different behaviors in children with food or pollen allergy. We found IL-12 and sCD30 levels in pollen-allergic patients that agree with the classical T-helper (Th) 1/Th2 paradigm of allergy. In contrast, serum IL-12 levels were increased in food-sensitized children, suggesting a different immunologic pathogenesis.     

Food allergy after liver transplantation in children: a prospective study

Food allergy has been increasingly reported in children who had orthotopic liver transplantation (OLT). We aimed to conduct a prospective study to investigate the prevalence of sensitizations and food allergy in pediatric OLT recipients. We also aimed to identify potential risk factors. The study group consisted of 28 children (14 male, 14 female, mean age 4.96 ± 0.76 yrs) who had OLT. Total eosinophil count (TEC), total IgE, and specific IgEs were studied before and 3, 6, 12 months after OLT. Six patients (21%) developed multiple food allergies. Mean age of six patients at OLT who developed food allergy was younger compared to the non‐food allergy group (10.2 months vs. 68.9 months, p < 0.05). Food allergy has been developed within 1 yr in 5, and in 20 months in one patient after OLT. All six patients had cow’s milk and egg allergy after OLT. Five children developed wheat, one children developed lentil and another one developed peach allergy in addition to cow’s milk and egg allergy. Out of six food‐allergic patients after OLT, four children developed Epstein–Barr virus (EBV) infection prior to food allergy. Before OLT, TECs and total IgE levels were not differed among food allergic and non‐food allergic patients (p > 0.05). Mean of TECs were significantly higher in food allergic group compared to non‐food allergic group at each time point after OLT (p < 0.05). Though statistically insignificant, mean of total IgE levels were also higher in the food allergic group (p > 0.05). These findings suggest that food allergy should be considered after OLT in patients who are younger than 1 yr of age, who developed hypereosinophilia, high total IgE levels or EBV viremia.     

Peanut seed storage proteins are responsible for clinical reactivity in Spanish peanut‐allergic children

Background: Seed storage proteins (SSP; Ara h 1, Ara h 2, Ara h 3) have been shown to be major peanut allergens, although recently, peanut lipid transfer protein has been reported to be an important allergen in the Mediterranean area. We sought to investigate the sensitization pattern to peanut SSP and vegetable pan‐allergens in a group of peanut‐allergic children compared with a peanut‐tolerant group. Methods: One hundred and twenty‐three children who presented with food allergy were included in the study. Tolerance to peanut ingestion was assessed. Specific IgE was determined by ImmunoCAP, and microarray ISAC was performed. Sensitization frequencies and levels of specific IgE were compared between groups. Results: Fifty‐five of 123 children presented symptoms upon contact or ingestion. Frequency of sensitization to Ara h 1, Ara h 2, and Ara h 3 was 60.0%, 72.7%, and 43.6%, respectively, in the group of allergic children vs. 7.4%, 1.5%, and 7.4% in the group of tolerant children. Levels of specific IgE against Ara h 1, Ara h 2, and Ara h 3 were significantly higher in the allergic group (p < 0.001). The frequency of sensitization and the levels of specific IgE against Cor a 8 (36.4% vs. 16.2%) were significantly higher in the allergic children, whereas no significant differences were found for Pru p 3. No differences were seen for other pan‐allergens. Patients sensitized to SSP, regardless of sensitization to nsLTP, were allergic rather than tolerant. Conclusion: In our population, peanut‐allergic children were mainly sensitive to SSP. A few patients were also sensitive to some nsLTPs. No differences were shown in other pan‐allergens.     

Analysis of basophil activation by flow cytometry in pediatric house dust mite allergy

Detection of allergen‐induced basophil activation by flow cytometry has been shown to be a useful tool for allergy diagnosis. The aim of this study was to assess the potential of this technique for the diagnosis of pediatric house dust mite allergy. Quantification of total and specific IgE and basophil activation test were performed to evaluate mite allergic (n = 24), atopic (n = 23), and non‐allergic children (n = 9). Allergen‐induced basophil activation was detected as a CD63‐upregulation. Receiver operating characteristics (ROC) curve analysis was performed to calculate the optimal cut‐off value of activated basophils discriminating mite allergic and non‐allergic children. ROC curve analysis yielded a threshold value of 18% activated basophils when mite‐sensitized and atopic children were studied [area under the curve (AUC) = 0.99, 95% confidence interval (CI) = 0.97–1.01, p < 0.001] with a sensitivity and specificity of 96% for 16 μg/ml mite extract. Analysis of the data obtained with 1.6 μg/ml mite extract defined a cut‐off value of 8% activated basophils (AUC = 0.96, 95% CI = 0.91–1.01; p < 0.001) with a sensitivity of 82% and specificity of 100%. Comparison between mite allergic and non‐allergic children produced a cut‐off of 8% activated basophils (AUC = 1.0) with 16 μg/ml allergen extract and a sensitivity and specificity of 100%. The same threshold and specificity values were obtained with 1.6 μg/ml extract (AUC = 97%, 95% CI = 0.92–1.02; p < 0.001) but sensitivity decreased to 83%. Two atopic children showed negative skin prick and basophil activation tests and high specific IgE (>43 kU/l) values for Dermatophagoides pteronyssinus allergen. They also showed positive prick (wheal diameter >1.0 cm) and basophil activation (>87%) tests and high specific IgE (>100 kU/l) with shrimp allergen. Shrimp sensitization was demonstrated by high levels of Pen a 1‐specific IgE (>100 kU/l). Cross‐reactivity between mite and shrimp was confirmed by fluorescence enzyme immunoassay (FEIA‐CAP) inhibition study in these two cases. This study demonstrated that the analysis of allergen‐induced CD63 upregulation by flow cytometry is a reliable tool for diagnosis of mite allergy in pediatric patients, with sensitivity similar to routine diagnostic tests and a higher specificity. Furthermore, this method can provide additional information in case of disagreement between in vivo and in vitro test results.     

川崎病患儿血清脑利钠肽的水平改变及其与肌钙蛋白的对比分析

目的通过观察到川崎病（KD）患儿脑利钠肽（BNP）的水平变化,并与肌钙蛋白Ⅰ（cTnⅠ）比较,探讨其在KD早期诊断中的作用。方法选择住院KD患儿2l例作为研究对象,20例健康体检儿童作为对照组。对KD组及对照组采用酶联免疫吸附法测定血浆BNP、cTnI浓度,并行心脏多普勒超声检查测定冠状动脉内径。结果KD患儿血浆BNP水平[（517．26±213．40）μg／L]明显高于对照组[（37．55±7．56）μg／L],差异有非常显著性（P〈0．01）;cTnI浓度[（0．31±0．17）μg／L]也高于对照组[（0．13±0．04）μg／L],差异有显著性（P〈0．01）。KD患儿BNP异常率（100％）明显高于cTnI（47．7％）,差异有非常显著性（P〈0．01）;冠状动脉病变组血浆BNP、cTnI水平明显高于非冠状动脉病变组;典型KD患儿及不完全型KD患儿BNP及cTnI血浆水平间差异无显著性（P〉0．05）。结论KD患儿血浆BNP、cTnI浓度均明显升高,而BNP具有更高的特异性及灵敏度。血浆BNP水平测定有助于KD的诊断,尤其是不完全型KD早期诊断。