反复发作性过敏性紫癜患儿血清过敏原特异性IgE检测

目的进一步了解血清过敏原特异性IgE在儿童反复发作性过敏性紫癜中的作用,探讨各种变应原与疾病发病的关系。方法采用酶联免疫吸附试验检测130例反复发作性过敏性紫癜患儿的血清过敏原特异性IgE。结果130例患儿中血清总IgE水平>50IU/ml者103例,阳性率80.47%。其中73例(75.3%)对两种以上过敏原呈阳性反应,30例(24.7%)对一种过敏原呈阳性反应。常见的吸入性过敏原为霉菌(29/130)、蒿类花粉(16/130)和尘螨(15/130)。食物组最常见的为牛奶(35/130)、蛋白类(26/130)、鱼类(15/130)和虾蟹(12/130)。结论反复发作性过敏性紫癜的发生与吸入性和食入性过敏原都有一定的相关性,霉菌和蛋白类食物是诱导反复发作性过敏性紫癜的主要致病原。特异性IgE检测可帮助筛选过敏原,对疾病的预防具有积极意义。     

朗格罕细胞上的IgE:遗传过敏性皮炎发病的新观点

遗传过敏性皮炎(AD)的发病机理仍不清楚,一般认为此病的内因包括免疫学和病理学的异常,外因似与食物过敏和常见的环境变应原等有关。但近来对AD病人的观察已超出了这一认识。约90％的AD病人经划痕或皮内法对吸入性变应原出现一种立即型反应,同时血清特异性IgE升高。在大多数病例中,这种对吸入性变应原的立即型过敏反应与哮喘和(或)过敏性鼻炎有关。IgE和吸入性变应原在AD发病上的确切作用仍不清楚。但     

过敏性紫癜患者血清过敏原特异性IgE检测

我们采用酶联免疫吸附试验检测100例过敏性紫癜患者的血清过敏原特异性IgE,以进一步了解血清过敏原特异性IgE在过敏性紫癜中的作用,探讨各种变应原与疾病发生的关系。100例患者中血清总IgE水平>50IU/mL者64例,阳性率64%。其中对两种以上过敏原呈阳性反应者19例(29.7%),对一种过敏原呈阳性反应者45例(70.3%)。吸入组中特异性IgE阳性最常见的致敏原为霉菌(21/100),其次为蒿类花粉(6/100)和尘螨(7/100)。食物组最常见的为牛奶(16/100),其次为蛋白类(8/100)、鱼类(7/100)和虾蟹(6/100)。过敏性紫癜的发生与吸入性和食物性过敏原都有一定的相关性,霉菌和蛋白类食物是诱导过敏性紫癜复发的主要变应原。特异性IgE检测可帮助筛查过敏原,对疾病的预防具有积极意义。     

湿疹及皮炎

20 0 0 30 60　遗传过敏性皮炎血清特异性 Ig E分析 /陈木开 (中山医大附一院皮肤科 )…∥中国皮肤性病学杂志 .- 2 0 0 0 ,14( 3) .- 151～ 152对广东地区 90例遗传过敏性皮炎 ( AD)患者血清行 Mast SIg E检测。Mast变应原检测系统是近年来发展起来的一种体外半定量检测血清特异性 Ig E方法。90例中 AD1组 53例 ,合并哮喘、过敏性鼻炎者占58.89% ,AD2 组 37例 ( 4 1.11% )为 AD患者无合并哮喘及过敏性鼻炎者。结果显示 :AD患者中 80 %伴有Ig E升高 ,发现螨类是 AD患者最常见的变应原 ,其特异性 Ig E(屋尘螨及粉尘螨 )阳性检出率…     

成人特应性皮炎患者疾病感知影响因素分析

正特应性皮炎(atopic dermatitis,AD)是一种慢性炎症性皮肤病,以湿疹样皮疹、皮肤干燥和严重瘙痒为主要特点。易反复发作,常伴发食物过敏、过敏性鼻炎和哮喘,可因感染、气候变化、精神压力、接触刺激物和过敏原加重[1]。AD常早期发生于婴儿期和儿童期,患儿症状常可在青春期得到改善,因此,我国学者多关注于婴儿期和儿童期AD患者,而对于 AD 成人患者的相关研究较为缺乏[2]。但50%的儿童期AD可持续到成年或成年发病,研究显示成人     

昆明地区1674例过敏原特异性IgE分析

目的了解昆明地区患者吸入性过敏原和食物过敏原特异性IgE抗体分布特点,为过敏性疾病防治提供参考。方法以2015年3月～2017年12月在昆明市第一人民医院就诊的1 674例过敏性疾病患者为实验对象。用欧蒙免疫印迹法检测血清过敏原特异性IgE抗体。结果 1 674例过敏性疾病患者中,吸入性过敏原以屋尘螨/粉尘螨检出率最高,食物过敏原以海洋鱼类组合检出率最高。婴幼儿期以食物过敏原过敏为主,随着年龄增长吸入性过敏原逐渐增多,而食物过敏原逐步减少。结论本地区吸入性过敏原以屋尘螨/粉尘螨较常见,食物过敏原以海洋鱼类组合较常见。血清过敏原的检测可为过敏性疾病的病因学诊断、治疗和预防提供帮助。     

血清特异性IgE检测在过敏性皮肤病病因筛查诊断中的应用

目的观察分析血清IgE检测在过敏性皮肤病病因筛查诊断中的临床应用效果。方法对300例过敏性皮肤病患者进行酶联免疫法检测血清变应原特异性IgE,筛查相应的过敏原,并进行比较分析。结果吸入性变应原特异性IgE检测排序前4位分别是户尘螨、屋尘螨、狗毛、猫毛;食入性变应原特异性IgE检测排序前4位分别是虾、蟹、鱼、鸡蛋;本组300例,变应原特异性IgE总反应285例(95.00%),阴性反应15例(5.00%);吸、食入组均阳性210例(70.00%),单纯吸入组50例(16.67%),单纯食入组25例(8.33%)。两组均阳性率对比单一组阳性率差异有统计学意义(P 0.05)。单纯吸入组与单纯食入组比较,差异有显著性(P0.05)。结论对于过敏性皮肤病采取血清IgE监测,可以筛查相应的过敏原,为临床病因诊断及脱敏治疗提供可靠依据。     

辽沈地区儿童特应性皮炎过敏原检测结果分析

目的 探讨辽沈地区儿童特应性皮炎（AD）常见过敏原的血清特异性IgE(sIgE)与皮肤点刺试验（SPT）结果及随年龄增长的变化,为其防治提供依据。方法 选取2017年1月—2021年7月于东北国际医院变态反应科门诊诊断为AD的患儿,且同时检测血清sIgE及行SPT,回顾性分析相关数据。结果 546例患儿sIgE阳性率为83.51%,SPT阳性率为59.16%;男女阳性率差异均无统计学意义（P> 0.05）。不同年龄段SPT吸入性过敏原阳性率由高到低依次为学龄前组、学龄组、青春期组、婴幼儿组,各组比较差异有统计学意义（P <0.05）。sIgE过敏原阳性率由高到低依次为婴幼儿组、学龄前组、学龄组、青春期组,其中婴幼儿组与学龄前组最常见过敏原是蛋清及牛奶,学龄组及青春期组最常见过敏原是尘螨组合。随着年龄增长,尘螨、艾蒿等吸入性过敏原阳性率呈上升趋势,而蛋清、牛奶、黄豆、牛羊肉等食入性过敏原阳性率逐渐降低。对于吸入性过敏原,两种检测方法的总体阳性率为69.96%,SPT阳性率为59.16%,血清sIgE阳性率为61.17%,两种检测方法阳性率差异无统计学意义（P> 0.05...     

温州地区402例过敏性疾病患者的过敏原检测与分析

目的分析温州地区过敏性疾病患者的主要过敏原类型和分布特征,为临床过敏性疾病的诊治和预防提供可靠的实验依据。方法采用德国Mediwiss Analytic Gmb H生产的Allergy Screen过敏原定量检测系统检测402例过敏性疾病患者血清中18种过敏原特异性IgE抗体(sIgE)含量,采用Roche E601分析仪检测患者血清中总IgE含量。结果温州地区402例过敏性疾病患者总Ig E阳性率为57.46%,s Ig E阳性率为78.86%;吸入性过敏原以户尘螨为主,阳性率45.02%,食入性过敏原以牛奶为主,阳性率26.12%;吸入性组过敏原阳性率64.18%高于食入性组53.23%,2组率比较差异有统计学意义(χ~2=9.933,P=0.010);不同性别间过敏原检出率为男165例(83.33%),明显高于女152例(74.51%),检出率比较差异有统计学意义(χ~2=4.692,P=0.030);402例患者以多种过敏原呈阳性反应为主,其中21.39%的患者仅对单一过敏原有阳性反应,17.91%的患者对2种过敏原有阳性反应,而3种及以上过敏原呈阳性反应的占39.56%。结论温州地区过敏性疾病患者血清中吸入性过敏原以户尘螨为主,食入性过敏原以牛奶为主,大多数患者易被多种过敏原致敏。通过对其过敏原进行筛查可为疾病的预防和治疗提供重要理论依据。     

贵州省毕节市1 627例过敏性疾病患者过敏原检测结果分析

目的通过对毕节市过敏性疾病患者进行过敏原分析,筛查常见过敏原,从而得出毕节市过敏性疾病患者的过敏谱。方法应用苏州浩欧博公司的变应原特异性IgE抗体检测试剂盒,采用体外血清酶联免疫检测方法,统计1 627例过敏性疾病患者的过敏原结果和种类。结果在1 627例过敏性疾病患者中,sIgE阳性率前3位为:树组合(柏树/榆树/梧桐/柳树/杨树)52.67%,动物皮毛(猫毛皮屑/狗毛皮屑)44.13%,霉菌组合(点青霉/分枝孢霉/烟曲霉/交链孢霉/根霉/毛霉)30.55%。结论贵州省毕节市过敏性疾病患者过敏谱以吸入性过敏原:树组合(柏树/榆树/梧桐/柳树/杨树)、动物皮毛(猫毛皮屑/狗毛皮屑)、霉菌组合(点青霉/分枝孢霉/烟曲霉/交链孢霉/根霉/毛霉)为主,通过对过敏原筛查可以为临床诊断、治疗提供依据,并为患者饮食忌口、避免接触相关过敏原及脱敏治疗提供帮助。     

Prognosis of Atopic Dermatitis

The course and development of atopic symptoms were followed up in 801 atopic dermatitis patients, in 207 allergic rhinitis or asthma patients, and in 517 control subjects. The patients were studied in the Dermatology Clinic during their teens and the follow-up studies were carried out at the ages of 22-41. Persistent or frequently relapsing dermatitis occurred in 77-91% of those who suffered from severe or moderate atopic dermatitis during their teens and in more than one half of those patients who only had mild dermatitis at the corresponding age. Atopic dermatitis had started in 13-17% of allergic rhinitis/asthma patients. At the time of the follow-up examination, severe dermatitis was seen in only six percent and moderate symptoms in 35% of atopic dermatitis patients. Dermatitis was generally seen in multiple loci: on the face, hands, extremities, and body. Deterioration of dermatitis in autumn and winter was experienced by one third to 88% of the atopic dermatitis patients. Psychic stress was experienced as a major aggravating factor in one half to two thirds of atopic dermatitis patients. Prick test positivity occurred in 62-89% of the dermatitis patients. Animal allergens, molds, grasses, birch, and house dust mite were the most common allergens. Associations between evident allergen exposure and deterioration of the dermatitis occurred in individual cases.     

Evaluation of RAST in atopic dermatitis

Eighty-two patients with atopic dermatitis were examined for specific IgE antibodies by RAST. A higher number of positive RAST reactions were found in patients with high serum IgE values and with coexisting asthma and/or allergic rhinitis. Positive RAST reactions against mite and house dust were found in many of these patients and even in about one-half of patients with atopic dermatitis only. The comparisons between intradermal tests and RAST were made with various allergens and the mite extract showed the best agreement between these two tests.     

Retrospective study of specific immunotherapy - what should be done in the future

In this retrospective study, data on 241 atopic patients treated with specific cutaneous immunotherapy during the 1985-2006 period at Allergy Clinic, University Department of Dermatology and Venereology, were reviewed. The following diagnoses were recorded: atopic dermatitis, pure or in combination with allergic rhinitis or allergic bronchitis, or allergic bronchitis and asthma, allergic rhinitis, allergic conjunctivitis, urticaria, and Quincke's edema. The aim was to retrospectively analyze clinical efficacy and laboratory findings in atopic patients undergoing specific immunotherapy. Before specific immunotherapy administration, eosinophil count, immunoglobulins, skin prick test, total IgE (RIST) and specific IgE (IgE UniCAP) were determined. The following allergens were included in specific immunotherapy: Dermatophagoides pteronyssinus, house dust mite (mixed or separately), mixed and single pollens (grass, tree, weed), feather, and animal dander. The most frequent allergens in 241 atopic patients were grass pollen mixture, Dermatophagoides pteronyssinus, ragweed, tree pollen mixture, cocksfoot, birch, animal dander, and feather. Treatment efficacy was demonstrated after 3 years of continuous therapy by clinical evaluation and with the same diagnostic procedure. After several months of therapy, initial clinical improvement was noticed in atopic dermatitis patients as well as in patients with respiratory diseases that were sensitive to airborne allergens. According to literature, specific immunotherapy was used as a treatment option, which may affect the natural course of allergic diseases. It reduces development of asthma in patients with allergic rhinitis and prevents the onset of new sensitizations.     

House dust mites on skin, clothes, and bedding of atopic dermatitis patients

Background  Atopic dermatitis is a common allergic condition in children, often associated with a positive skin reaction to house dust mite allergens.
Aim  To determine the presence of house dust mites on the skin, clothes, and bedding of patients with atopic dermatitis.
Methods  Nineteen patients with atopic dermatitis were examined during a 2-year period. Samples from affected and healthy skin surfaces were obtained with adhesive tape, and dust samples from bedding and clothes were collected with a vacuum cleaner at the start of the study and 3–6 weeks later, and examined for the presence of house dust mites. The findings were compared with those of 21 healthy controls.
Results  The most common mite species on skin were Dermatophagoides pteronyssinus and Dermatophagoides farinae , which were found in nine patients and three controls. The patient group showed a significantly larger percentage of samples with mites than did the control group (34.9% and 7.9%, respectively) ( P  < 0.001), and a significantly larger percentage of individuals with at least one positive sample (84.2% and 14.2%, respectively) ( P  < 0.0001). No correlation was found between the number of mites on the skin and clothes/bedding of patients, or between patients and controls with regard to the number of mites on the clothes and bedding.
Conclusions  Patients with atopic dermatitis showed a higher prevalence of mites on their skin than did healthy individuals, which could be involved in allergic sensitization and disease exacerbation.     

Prevalence of atopic dermatitis, allergic rhinitis and asthma in Taiwan: a national study 2000 to 2007

To study the prevalence of atopic dermatitis, allergic rhinitis, and asthma in Taiwan, we analysed the claims data of a nationally representative cohort of 997,729 enrolees from the National Health Insurance register from 2000 to 2007. Overall, 66,446 patients were diagnosed with atopic dermatitis, and 49.8% of them had concomitant allergic rhinitis and/or asthma. The overall 8-year prevalences of atopic dermatitis, allergic rhinitis, and asthma were 6.7%, 26.3% and 11.9%, respectively. Children and adolescents had significantly higher prevalences of these atopic diseases. The prevalence of atopic dermatitis in females was lower than that in males before the age of 8 years, but became higher after that. Patients with atopic dermatitis were more likely to have allergic rhinitis and asthma. Those having both atopic dermatitis and allergic rhinitis possessed an even higher risk for asthma (odds ratio 9.04). The numbers of visits for atopic dermatitis were highest in late spring to mid-summer. These data suggest that atopic diseases are common in Taiwan.     

Patch test reactions in atopic patients

Patch testing was carried out in 851 atopic patients; 181 atopic dermatitis (AD) patients were additionally tested with 50% dilutions of the test substances. The occurrence of allergic and irritant reactions was frequent, being 57% and 33% for AD patients aged 28-41 years and 19-27 years, respectively. Among age-matched allergic rhinitis (AR)/allergic conjunctivitis (AC) or asthma (A) patients, the number of allergic reactions varied from 25 to 30%, and for irritant reactions was 24%. In all groups, nickel, fragrance-mix, balsam of Peru and neomycin were the commonest allergens. Contact allergy to ingredients of topical medicaments was common among AD patients and patients with severe and long-lasting dermatitis were most frequently sensitized. However, sensitivity to multiple substances was not common among those patients. The number of irritant reactions was considerable, but 50% dilution of the test substances did not solve the problem.     

Eczematous reactions in atopic patients caused by epicutaneous testing with inhalant allergens

To determine whether inhalant allergens could induce eczematous lesions we studied 17 patients with atopic eczema (with or without allergic rhinitis), 13 patients with allergic rhinitis without atopic eczema and 10 healthy control subjects. The allergens, birch pollen (Betula verrucosa) and house dust mite (Dermatophagoides pteronyssinus), were applied in aluminium chambers for 48 h on clinically normal skin. In 17 patients with atopic eczema, six epicutaneous test reactions of the delayed type to birch pollen and three to house dust mite were seen at 48 or 72 h. In 13 patients with allergic rhinitis without eczema there was one delayed reaction to birch pollen and none to house dust mite. No delayed type test reactions to either allergen were seen in the controls. Biopsies of the positive test sites revealed an eczematous reaction with epidermal spongiosis and microvesiculation. Immunostaining of cryostat sections showed dermal cell infiltrates consisting of mainly T lymphocytes (ratio of T4:T8, 2-6:I) and to a lesser degree Langerhans and indeterminate T6+ cells. 50-90% of the cells were Ia+. The numbers of basophils and mast cells did not exceed 10-15%.     

特应性皮炎167例皮肤点刺试验结果分析

目的通过皮肤点刺试验(skin prick test,SPT)结果的分析,了解特应性皮炎(atopic dermatitis,AD)患者在不同年龄组、不同人群及伴有不同变应性疾病的变应原分布及种类。方法将167例患儿分为≤2岁组和>2岁组,采用德国默克集团Allergopharma公司的皮肤点刺液,选择标准化变应原:鸡蛋白、蛋黄、虾等,在前臂屈侧做点刺试验。结果167例患者中,SPT阳性65例,阴性102例,阳性率38.9%。2岁以下和2岁以上变应原种类明显不同,即2岁以下以食物过敏为主,如鸡蛋白、蛋黄、牛奶等。2岁以上逐渐过渡为以吸入物过敏为主,如艾蒿、粉尘螨、藜草等。合并哮喘的AD病人SPT阳性率较高。结论AD从婴幼儿以食物过敏为主,逐渐演变为儿童期及青春期以吸入性过敏为主。SPT易于操作,灵敏度高,对于儿童AD患者较为适用。     

Can atopy patch tests with aeroallergens be an additional diagnostic criterion for atopic dermatitis?

The complex pathomechanisms underlying skin lesions in atopic dermatitis (AD) result in variations of the clinical picture and frequent diagnostic difficulties. The purpose of this study was to evaluate the usefulness of atopy patch tests (APT) for aeroallergens in the diagnosis of AD. The study involved 115 adult patients with AD and 98 healthy volunteers (the control group). APTs for cat dander allergens, birch pollen, a mixture of house dust mite species and a mixture of 5 grass pollen allergens were applied for both groups. Positive reaction to at least one test allergen was found in 53.9% patients compared to 6.2% in the control group (p<0.001). The most frequent hypersensitivity (45.2%) observed was to house dust mite allergens. Polyvalent allergy to 2-4 allergens was found in 56.5% patients. The specificity of tests exceeded 75%, whereas the sensitivity varied from 18 to 66%. CONCLUSIONS: 1. Atopy patch tests, which are characterised by considerable specificity, confirm the role of polyvalent contact hypersensitivity to aeroallergens in the development of atopic dermatitis. 2. Positive aeroallergen ATP results are observed in the majority of patients and can thus be regarded as an additional diagnostic criterion in atopic dermatitis.     

Oral allergy syndrome in patients with airborne pollen allergy treated with specific immunotherapy

According to literature, approximately 20%-70% of patients sensitized to pollen allergens experience oral allergy syndrome (OAS) symptoms after eating raw fruits and vegetables. There is no standard treatment established for OAS except avoiding implicated food. However, in patients with airborne pollen allergy treated with specific immunotherapy (SIT), an improvement of OAS symptoms has been reported in 30% to even 84% of individuals examined. The aim of the present study was to evaluate the prevalence of OAS symptoms in patients with various manifestations of pollen airborne allergy (atopic dermatitis (AD), asthma, allergic rhinitis) treated with subcutaneous type of SIT. In addition, the most common patterns of cross-reactivity in OAS were analyzed and correlations between OAS symptoms and patient age, type of sensitizing pollen allergens and atopy manifestations investigated. Also, the relationship between SIT duration and clinical improvement of both OAS symptoms and pollen allergy symptoms was analyzed. The study included 57 patients with airborne allergy treated with allergen vaccination (60% male and 40% female). Allergic rhinitis was diagnosed in 71%, AD in 19%, AD and asthma in 4%, allergic rhinitis and asthma in 4%, and both AD and allergic rhinitis in 2% of study patients. Twenty-eight percent of study patients complained of overt symptoms of OAS (22% of allergic rhinitis patients and 27% of AD patients); 69% of the subjects presenting with OAS showed polyvalent airborne allergy to pollens and 31% were sensitized to only one group of pollen allergens (mostly grass pollens, tree pollens and mugwort pollens). There was no statistically significant correlation between the presence of OAS symptoms and patient diagnosis, patient age and type of allergen vaccination used. According to patients' opinion, SIT significantly improved oral symptoms in 50% of study patients, 44% reported no impact of SIT on OAS symptoms and 6% of patients observed worsening of OAS symptoms after unintentional ingestion of implicated food during the course of SIT. The study revealed OAS as a significant problem in patients sensitized to various pollen allergens. The results on OAS prevalence in atopic subjects (28%) were consistent with some literature data. There was clear association between OAS and polyvalent airborne allergy (69%). Cross-reactivity patterns were typical (for example, tree pollen allergy - intolerance of apples, carrots and potatoes; grass pollen allergy - intolerance of kiwi fruit and tomatoes). Questionnaire analysis indicated that subcutaneous SIT significantly alleviated OAS symptoms associated with ingestion of the responsible fruit and vegetables in half of study subjects. Further evaluation of the duration/persistence and stability of the phenomenon is planned for the future.