135例成人过敏原皮肤点刺试验的过敏原初步分析

目的 了解成人哮喘及慢性咳嗽患者过敏原分布情况.方法 选取112例患者(包括46例哮喘患者及66例慢性咳嗽患者)及23名正常对照者过敏原皮肤点刺试验(SPT)结果分为哮喘组、慢性咳嗽组及正常对照组进行分析.结果 哮喘组中,最常见的变应原依次为粉尘螨、屋尘螨、热带螨、狗毛、猫毛、德国小蠊,其中粉尘螨、屋尘螨的阳性率均在60％以上;慢性咳嗽组中,最常见的变应原依次为屋尘螨、粉尘螨、热带螨、猫毛、德国小蠊、美洲大蠊等;哮喘组SPT阳性率高于慢性咳嗽组,慢性咳嗽组SPT阳性率高于正常对照组,差异均具有统计学意义.典型哮喘与咳嗽变异性哮喘SPT阳性率无明显差别.结论 引起哮喘与慢性咳嗽的主要变应原因素为屋尘螨、粉尘螨、热带螨,SPT在变应性疾病的变应原因素诊断中具有一定意义.     

135例成人过敏原皮肤点刺试验的过敏原初步分析

目的了解成人哮喘及慢性咳嗽患者过敏原分布情况。方法选取112例患者（ig括46例哮喘患者及66例慢性咳嗽患者）及23名正常对照者过敏原皮肤点刺试验（SPT）结果分为哮喘组、慢性咳嗽组及正常对照组进行分析。结果哮喘组中,最常见的变应原依次为粉尘螨、屋尘螨、热带螨、狗毛、猫毛、德国小蠊,其中粉尘螨、屋尘螨的阳性率均在60％以上;慢性咳嗽组中,最常见的变应原依次为屋尘螨、粉尘螨、热带螨、猫毛、德国小蠊、美洲大蠊等;哮喘组SPT阳性率高于慢性咳嗽组,慢性咳嗽组SPT阳性率高于正常对照组,差异均具有统计学意义。典型哮喘与咳嗽变异性哮喘SPT阳性率无明显差别。结论引起哮喘与慢性咳嗽的主要变应原因素为屋尘螨、粉尘螨、热带螨,SPT在变应性疾病的变应原因素诊断中具有一定意义。     

Reproducibility and use of low-concentration skin prick test.

We aimed to evaluate the reproducibility of the skin prick test performed with serial 1:4 dilutions of commercial standardized extracts in comparison with serum-specific IgE and the undiluted commercial extract. Twenty-four subjects sensitized to one (17 cases) or two (seven cases) inhalant allergens were selected and submitted to duplicate skin prick tests with concentrated commercial allergenic extracts or with serial 1:4 dilutions of the same extracts in two different examinations 7 days apart. Blood samples were obtained from 17 of the 24 patients for specific IgE determination. No statistically significant within-patient variations in the area of the wheal in skin prick tests done 1 week apart were found up to the eighth dilution (1:256) of the commercial allergen. On a patient-by-patient basis, only some dilutions showed a statistically significant correlation between allergen-specific IgE and the wheal area elicited by the same allergen, and a significant correlation was found between the wheal elicited by 10 mg/ml histamine and both the concentrated and diluted allergens (up to the sixth dilution). In polysensitized patients, the allergen producing the largest wheal when used in concentrated form did not produce the same result when diluted. The skin prick test with low-potency allergens was reproducible in individual patients even after a 7-day interval up to a 1:256 dilution of the commercial extract, although there was no clear correlation with allergen-specific IgE concentration. In polysensitized patients, the use of high-potency or low-potency allergens for skin prick tests can lead to different conclusions regarding the relative importance of each allergen.     

变态反应性疾病变应原的体内外诊断及分析

目的 应用变应原皮肤点刺试验(SPT)分析西安地区不同变态反应性疾病的主要变应原,同时应用UniCAP 100检泓血清特异性免疫球蛋白E(IgE),并对结果进一步评价.方法 我院变态反应门诊就诊的变态反应性疾病患者679例,选用19种常见的变应原进行SPT,比较不同疾病患者主要变应原阳性率的异同;其中116例患者同时抽取静脉血检测血清粉尘螨特异性IgE,并与SPT结果比较.结果 ①在所有变态反应性疾病患者中,粉尘螨、屋尘螨均是最主要的变应原,总的阳性率分别是49.78%和43.00%,其次依次为蒿属花粉、霉菌、悬铃木属花粉和树Ⅰ花粉等,总阳性率均在10%以上,上述变应原是西安地区变态反应性疾病的主要变应原;②羽毛、鸡蛋、牛奶、蒿属、虾和花生6种变应原的阳性率在4种变态反应性疾病组间比较差异有统计学意义(P<0.05),其余变应原的阳性率在各组间差异无统计学意义,哮喘及过敏性鼻炎组患者的主要变应原以吸入性变应原为主,而荨麻疹组及过敏性紫癜组患者的主要变应原除以上吸入变应原外,还包括鸡蛋、牛奶、虾和花生等食人性变应原;③以血清特异性IgE为标准,以"+++及以上"为SPT阳性标准时的诊断价值高于以"++及以上"为SPT阳性标准,且IgE定量与SPT风团直径呈对数关系(r=0.629,P<0.05).结论 粉尘螨、屋尘螨、蒿属花粉、霉菌、悬铃木属花粉和树Ⅰ花粉等变应原是西安地区变态反应性疾病的主要变应原;不同疾病的主要变应原稍有不同;IgE定量与SPT风团直径呈对数关系,两者检测结果可以互补.     

变态反应性疾病变应原的体内外诊断及分析

目的应用变应原皮肤点刺试验(SPT)分析西安地区不同变态反应性疾病的主要变应原,同时应用UniCAP100检测血清特异性免疫球蛋白E(IgE),并对结果进一步评价。方法我院变态反应门诊就诊的变态反应性疾病患者679例,选用19种常见的变应原进行SPT,比较不同疾病患者主要变应原阳性率的异同;其中116例患者同时抽取静脉血检测血清粉尘螨特异性IgE,并与SPT结果比较。结果①在所有变态反应性疾病患者中,粉尘螨、屋尘螨均是最主要的变应原,总的阳性率分别是49.78%和43.00%,其次依次为蒿属花粉、霉菌、悬铃木属花粉和树Ⅰ花粉等,总阳性率均在10%以上,上述变应原是西安地区变态反应性疾病的主要变应原;②羽毛、鸡蛋、牛奶、蒿属、虾和花生6种变应原的阳性率在4种变态反应性疾病组间比较差异有统计学意义(P<0.05),其余变应原的阳性率在各组间差异无统计学意义,哮喘及过敏性鼻炎组患者的主要变应原以吸入性变应原为主,而荨麻疹组及过敏性紫癜组患者的主要变应原除以上吸入变应原外,还包括鸡蛋、牛奶、虾和花生等食入性变应原;③以血清特异性IgE为标准,以"+++及以上"为SPT阳性标准时的诊断价值高于以"++及以上"为SPT阳性标准,且IgE定量与SPT风团直径呈对数关系(r=0.629,P<0.05)。结论粉尘螨、屋尘螨、蒿属花粉、霉菌、悬铃木属花粉和树Ⅰ花粉等变应原是西安地区变态反应性疾病的主要变应原;不同疾病的主要变应原稍有不同;IgE定量与SPT风团直径呈对数关系,两者检测结果可以互补。     

Food intolerance and skin prick test in treated and untreated irritable bowel syndrome

AIM: To correlate the clinical features of treated and untreated patients with irritable bowel syndrome (IBS) to the results of skin prick test (SPT) for food and inhalant allergens. METHODS: We recruited 105 subjects to form three different target groups: treated group (n=44) undergoing treatment for IBS, untreated group (n=31) meeting the RomeⅡcriteria without treatment for IBS, control group (n=30) with no IBS symptoms. RESULTS: SPT results were different among the three groups in which SPT was positive in 17 (38.6%) treated patients, in 5 (16.1%) untreated patients and in 1 (3.3%) control (P<0.01). The number of positive SPTs was greater in the IBS group than in the control group (P< 0.001). The number of positive food SPTs was higher in the treated IBS group than in the untreated IBS group (P=0.03). CONCLUSION: Positive food SPT is higher in IBS patients than in controls.     

Does skin prick test correlate with basophil-associated mite-specific IgE in atopic children?

Skin prick test (SPT), as the standard diagnostic tool for immediate hypersensitivity to aeroallergens, is an expression of IgE-dependent mediator release from dermal mast cells. Though probably involved in the late-phase response, peripheral blood basophils (PBB) don't seem to participate in the immediate hypersensitivity response in the skin. We aimed to assess a possible correlation between the SPT to mites and levels of basophil-associated mite-specific IgE. We sequentially enrolled 15 children with allergic rhinitis and documented class > II mite sensitization, mean age 13 years (range 9.5-18), 11 males, 4 females. Symptoms score was determined using a validated questioner. SPT area under the curve (AUC) for 10 common respiratory allergens was measured in all patients. Heparinized blood after basophil enrichment, was lysed with CHAPS. Determination of allergen-specific and total IgE in serum and cell lysate supernatant was performed using standard commercial kits. Basophil-associated, mite-specific IgE could be reliably determined only in 10 patients with a skin reaction greater than 70 mm2, OR 36 (95% CI 1.8-732, p = 0.02). We found a strong linear correlation (R2 = 0.74, p = 0.001) between mite-specific basophil-associated IgE density (IgE molecules per cell) and the SPT AUC. This finding suggests that skin mast cell precursors and basophil both bind specific IgE at a common site prior to the arrival of mast cells to the skin.     

Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review

BackgroundA previous survey on allergens used by Mexican allergists in their skin prick test (SPT) panel showed wide variation. Humidity varies in different zones of Mexico. This might lead to differences in natural exposure and allergic sensitisation throughout the country. We aim to describe the SPT sensitivity patterns in the different climatic zones in Mexico and to show the usefulness of a structured SPT chart-review including multiple clinics in obtaining these allergen sensitisation patterns.Methods: A retrospective, structured chart-review of SPT results was undertaken in allergy clinics throughout Mexico. Ratios of SPT positivity were calculated for individual allergens, per climatic zone and nation-wide. Per allergen group the most important allergens were identified. Statistically significant differences between zones and the nation-wide data were tested with Pearson's Chi-squares test.Results4169 skin test charts were recollected. The most important allergens causing sensitisation were very similar in different zones, despite climate variation. The allergen with highest ratio of SPT positivity was Dermatophagoides pteronyssinus (51%), with trees (Ash-27%, Alder-22%, Oak19%), and Bermuda grass (26%) as second and third. In the hot zones (humid and dry) Aspergillus was statistically significant more frequently than in more temperate zones. Cockroaches thrive in big cities and humid zones and Mesquite and Poplar in dry zones. Weeds are less important.ConclusionMexico has its own SPT sensitisation pattern, which is different from America and Europe. A structured chart-review of SPT results is able to show this and might be a tool for allergists in other countries.     

Agreement rate of skin prick test with tissue eosinophil count in patients with nasal polyps

The pathogenetic mechanism of nasal polyps remains unknown, although allergy has been cited as an important factor in the etiology of nasal polyposis. Currently there is no definite histological criterion for differentiation of allergic from inflammatory nasal polyp. However, in a few studies, tissue eosinophil count has been used for this. This study aimed to find out the agreement rate of skin prick test and tissue eosinophil count in patients with nasal polyposis. Twenty five patients (18 males, 7 females) with nasal polyp were enrolled in this study. For each patient tissue sample from polyp material was taken for histopathological investigation. Moreover, skin prick test was performed for each patient using eleven common aeroallergens. Skin prick test was positive in 48% of the patients. Tissue eosinophil count of more than 50% was found in 75% of skin prick positive and in 69.2% of skin prick negative patients. Also tissue eosinophil count of more than 50% was found in 69.2% of patients with typical allergic symptoms as well as 75% of patients without allergic symptoms. No agreement was found between skin prick tests and tissue eosinophil counts in patients with nasal polyp. Also no difference was found between the tissue eosinophil counts in allergic and non allergic patients. Considering these results, it can be concluded that having a high tissue eosinophil count in patients with nasal polyp does not indicate that the polyp is allergic.     

呼出一氧化氮监测联合变应原皮肤点刺试验在儿童哮喘诊治中的应用性研究

目的 研究呼出一氧化氮监测联合变应原皮肤点刺试验在儿童哮喘诊治中的应用价值.方法 选取72例哮喘患儿与同期72例正常儿童,对比其呼出一氧化氮指标及哮喘患儿变应原皮肤点刺试验结果;观察患儿治疗前后呼出一氧化氮变化情况.结果 治疗前患儿组呼出气一氧化氮浓度明显高于正常组,治疗后该浓度明显下降;患儿对12种变应原均存在一定程度的过敏反应,其中屋尘螨及粉尘螨总阳性率最高.结论 呼出一氧化氮及变应原皮肤点刺试验能够有效指示儿童哮喘的发生,在指导治疗中起到关键作用.     

烟台地区过敏原皮肤点刺试验结果分析

目的了解烟台地区过敏性疾病的主要变应原,为过敏性疾病流行病学研究及临床诊断、治疗和预防提供重要依据。方法应用阿罗格点刺试液进行皮肤点刺试验,过敏原包括霉菌Ⅰ、杂草、玉米、屋尘螨、粉尘螨、烟曲霉、豚草、禾本科谷类、黎科、动物毛、羽毛、啤酒花、树Ⅰ、水果、小虾、羊肉、花生、鸡蛋、牛奶和鲑鱼。结果508例皮肤点刺试验,282例皮试阳性,阳性率55.51%。皮试阳性率最高的前五位的过敏原(皮试阳性率10%)依次是屋尘螨、粉尘螨、豚草、树Ⅰ、烟曲霉。尘螨过敏原(粉尘螨和屋尘螨)皮试阳性率明显高于其他过敏原(卡方检验,P0.01)。呼吸道过敏病和皮肤过敏性疾病常见过敏原致病的可能性更大。儿童组皮试阳性率明显高于成人组(卡方检验,P0.01);吸人性过敏原皮试阳性率明显高于食物类过敏原(卡方检验,P0.01)。结论烟台地区皮试阳性率最高的过敏原依次是屋尘螨、粉尘螨、豚草、树Ⅰ、烟曲霉,其中尘螨皮试阳性率明显高于其他过敏原。吸人性过敏原为常见过敏原。与成人相比,过敏原导致儿童过敏性疾病发病的可能性更大。     

Sensitivity of the skin prick test and specificity of the serum-specific IgE test for airway responsiveness to house dust mites in asthma.

BACKGROUND: The concept that asthma diagnosis based on allergen-specific IgE levels in serum is more accurate than diagnosis based on skin test reactivity is controversial. OBJECTIVE: To determine the atopy parameter that correlates most closely with airway reactivity to house dust mites in asthma. METHODS: Forty-three asthma cases were examined retrospectively for data on Dermatophagoides farinae-specific bronchoprovocation, serum-specific IgE, and skin prick tests. RESULTS: The maximal decreases in FEV1 following bronchoprovocation were correlated significantly with both the IgE levels and skin test scores. The accuracies of the tests were highest at a cutoff value of class 4 or higher for the IgE and of 3+ or higher for the skin test. At the cutoff values, the accuracies of both tests were similar (70% vs. 70%). The sensitivity of the skin test (81%) was higher than that of the IgE test (67%), whereas the specificity of the IgE test (71%) was higher than that of the skin test (52%). The sensitivity of the skin test was 91% at 2+ or higher, and the specificity of the IgE test was 95% at class 6 or higher. CONCLUSION: These results suggest that both the specific IgE level and the skin test reactivity are useful parameters in the prediction of positive airway responses to house dust mites in asthma. However, the skin test is more sensitive, whereas the IgE test is more specific. Therefore, these tests can be used in a complementary fashion (i.e., the skin test for screening and the specific IgE test for confirmation of the relevant allergen).     

Association between skin prick test and serum specific immunoglobulin E to American cockroach allergens in allergic rhinitis patients

Introduction and objectivesAmerican cockroach is a common aeroallergen sensitization in allergic rhinitis (AR) patients. Association between skin prick test (SPT) and specific immunoglobulin E (sIgE) to American cockroach allergen remains uncertain. This study aimed to evaluate the association between SPT and sIgE to American cockroach allergen in patients with AR.Materials and methodsThis cross-sectional study was conducted in Thai AR patients aged 6–25 years from September 2013 to October 2014. SPT and sIgE to American cockroach allergen were performed and the correlation was calculated using SPSS Statistics version 18.ResultsSixty-seven AR patients, with median age of 15 years were included in this study. SPT and sIgE to American cockroach allergen showed a positive result in 68.7% and 58.2% cases, respectively. Positive SPT or positive sIgE to American cockroach was found in 79.1%. Thirty-two patients (47.8%) tested positive for both SPT and sIgE to American cockroach allergen. Fourteen from a total of 67 cases (20.9%) with negative sIgE had positive SPT to American cockroach, while seven cases (10.4%) with negative SPT had positive sIgE to American cockroach. Moderate correlation was observed between mean wheal diameter (MWD) and sIgE level to American cockroach (r = 0.465, p = 0.001). No significant correlation was found between MWD of SPT or sIgE level to American cockroach and AR severity.ConclusionA moderate correlation was observed between MWD of SPT and sIgE level to American cockroach. If SPT is negative in allergic rhinitis patients highly suspected of having American cockroach allergy, serum sIgE should be considered and vice versa.