玉屏风颗粒辅助治疗特发性荨麻疹疗效观察及1018例慢性荨麻疹患者过敏原检测结果分析

目的 探讨玉屏风颗粒辅助治疗慢性特发性荨麻疹疗效观察,及慢性荨麻疹患者检测血清特异性IgE(sIgE)和特异性IgG(sIgG)对临床的指导及意义.方法 分析1018例慢性荨麻疹患者食物性过敏原和吸入性过敏原sIgE及食物sIgG结果 ;其中诊断慢性特发性荨麻疹患者106例,其中53例联合使用氯雷他定及玉屏风治疗,53例患者仅使用氯雷他定治疗,疗程4周,治疗结束后对治疗疗效及结果 进行分析,同时停药4周及8周后观察复发情况.结果 1018例慢性荨麻疹患者食物sIgG和sIgE的检测结果 不一致(P<0.01).0~15岁组阳性率最高,不同性别阳性率差异无统计学意义(P>0.05).治疗4周后,联合组治疗有效率为81.1%(43/53),对照组有效率为67.9%(36/53),联合组治疗优于对照组(P<0.05).停药4周后联合组复发率为9.3%(4/43),对照组复发率为22.2%(8/36);停药8周后联合组复发率为16.3%(7/43),对照组复发率为36.1%(13/36).联合组明显优于对照组(P<0.05).结论 对反复发作的慢性荨麻疹患者联合测定吸入性sIgE和食物过敏原sIgE及sIgG是寻找慢性荨麻疹患者过敏原的有效方法 ,为变态反应性疾病的预防、诊断和治疗提供依据.氯雷他定联合玉屏风颗粒对慢性特发性荨麻疹治疗有效,能降低复发率.     

275例变态反应性皮肤病患者血清总IgE和特异性IgE抗体检测分析

目的 研究血清中总IgE抗体和特异性IgE（sIgE）抗体在三种变态反应性皮肤病中的含量和过敏原种类.方法 使用免疫印迹方法,对275例变态反应性皮肤病患者总IgE及sIgE抗体水平进行检测.结果 三种变态反应性皮肤病总IgE阳性率为71.27％,差异具有统计学意义（x2=20.105,P＜ 0.001）,其中sIgE阳性者所占比率为62.76％.过敏原检出阳性率吸入组较食人组高,分别为174例（64.93％）和94例（35.07％）,吸人组中最高为户尘螨/屋尘为62例（23.13％）,食入组中最高为贝/鱼/虾/蟹为28例（10.45％）.结论 血清中多种过敏原参与了变态反应性皮肤病,通过测定血清总IgE水平,以及检测特异性过敏原sIgE水平,研究患者发生疾病的过敏原,可以为临床诊疗该类疾病提供一定的参考.     

Mediwiss敏筛定量过敏原检测在过敏性疾病诊断及防治中的应用

目的:分析过敏性疾病患者血清中过敏原特异性IgE和血清总IgE,为更好地诊断和防治过敏性疾病提供可靠的科学依据。方法:采用德国Mediwiss敏筛过敏原定量检测系统对152例过敏性患者进行血清特异性IgE和总IgE水平检测。结果:152例过敏性疾病患者中总IgE阳性为141例(92.7%),吸入组过敏原阳性主要为户尘螨粉尘螨、柏榆梧桐柳三角叶杨、点青霉分枝孢霉曲霉交链孢霉;食物组阳性率依次为鱼虾蟹、鸡蛋白鸡蛋黄、牛肉羊肉等。结论:采用特异性好、敏感度高的免疫印迹技术检测过敏患者血清中总IgE和特异性IgE,能帮助临床医生确认过敏体质和找到过敏原,对过敏性疾病的预防、诊断和治疗有指导意义。     

过敏原检测在哮喘诊断及防治中的意义

目的探讨定量过敏原检测在哮喘诊断及防治中的意义。方法采用allergyscreen过敏源诊断试剂盒检测83例哮喘患儿血清过敏原特异性IgE抗体和总IgE抗体。结果本组患儿总IgE抗体阳性率61.5%,不同过敏原特异性IgE抗体以户尘螨粉尘螨阳性率(71.2%)最高。结论户尘螨粉尘螨是3岁以上小儿哮喘发作的主要诱因。支气管哮喘患儿总IgE水平增高。     

川芎嗪对哮喘大鼠Th1/Th2型细胞因子水平的影响

目的　探讨川芎嗪对哮喘大鼠Th1/Th2细胞亚群反应的影响及防治哮喘的作用机制。方法　 5 0只SD大鼠哮喘模型 ,分为正常对照组 (A) ,哮喘模型组 (B) ,激素对照组 (C) ,川芎嗪组(D) ,联合用药组 (E) ,用酶联免疫吸附试验 (ELISA)检测支气管肺泡灌洗液 (BALF)中白介素 4 (IL 4 )、γ干扰素 (IFN γ)水平及白介素 4 /γ 干扰素的比值 (IL 4 /IFN γ)的变化。结果　与正常组比较 ,哮喘模型组BALF中IL 4水平、IL 4 /IFN γ比例显著升高 (P <0 0 1) ,IFN γ水平显著降低 (P <0 0 1) ;与哮喘模型组比较 ,川芎嗪组和地塞米松组IL 4水平和IL 4 /IFN γ比例均显著降低 (P <0 0 1)。结论　川芎嗪具有抑制哮喘Th2细胞亚群优势反应和调节免疫平衡的作用。     

穴贴定喘膏对过敏性哮喘豚鼠IL3、IL5和IgE的影响

目的　探讨穴贴定喘膏治疗过敏性哮喘模型豚鼠的作用机理。方法　用 10 %卵蛋白液给豚鼠致敏 ,2周后再用1%的该溶液雾化吸入 ,以诱发豚鼠哮喘 ,然后将发作的哮喘豚鼠随机分为模型组、先声咳喘宁组 (7 5ml·kg-1)、穴贴定喘膏组(1g·kg-1、3g·kg-1) ,同期另设一正常组。先声咳喘宁组豚鼠灌胃给药 ,穴贴定喘膏组豚鼠经皮给药。每日给药 1次 ,连续 7日。其间在给药 1h后 ,诱发哮喘 1次。 1周后取豚鼠血清 ,测定IL3 、IL5和IgE水平。结果　穴贴定喘膏能降低血清IL3 、IL5和IgE ,与模型组比较具有显著性差异 (P <0 0 5 )。结论　穴贴定喘膏治疗过敏性哮喘作用机理与降低IL3 、IL5和IgE有关。     

舌下含服粉尘螨滴剂联合治疗变应性哮喘临床观察

目的评估舌下含服"粉尘螨滴剂"联合治疗变应性哮喘的疗效和安全性。方法采用随机、平行对照的研究方法,对符合变应性哮喘诊断标准并且粉尘螨变应原皮肤点刺试验呈阳性的患者分成两组,治疗组51例,对照组49例,均遵照GINA方案给予常规治疗。治疗组在此基础上联合粉尘螨滴剂舌下含服脱敏治疗,在治疗第2、4、8、12、16、20周进行随访,治疗第25周结束临床观察。治疗结束时进行哮喘控制水平评定,比较两组疗效及治疗前后第一秒用力呼气肺活量占预计值的百分比(FEV1%)、最大呼气流量(PEF)、血嗜酸性粒细胞计数、痰嗜酸性粒细胞计数、血清粉尘螨特异性IgE(sIgE)、特异性IgG4(sIgG4)及不良事件。结果治疗组病情评定达到控制34例,部分控制13例,未控制4例,总有效率92.15%;对照组病情评定达到控制16例,部分控制23例,未控制10例,总有效率79.59%;治疗组的总有效率明显高于对照组,两组间差异有统计学意义(P<0.05);治疗前后的FEV1%、PEF(L/min)、血EOS(个/ml)、痰EOS(个/ml)、sIgG4(ug/ml)相比差异有统计学意义(P<0.05或P<0.01);治疗期间未发生严重不良事件。结论舌下含服"粉尘螨滴剂"联合治疗变应性哮喘效果明显,安全可靠,可提高患者的生活质量。     

支气管哮喘及过敏性鼻炎患者总IgE与吸入变应原sIgE检测结果分析

目的 分析在支气管哮喘及过敏性鼻炎患者中总IgE(tIgE)及过敏原检测的指导价值.方法 从2016年12月至2018年6月于江苏省人民医院就诊且行tIgE、吸入性变应原sIgE(IsIgE)检测的患者中筛选出不伴有变应性鼻炎的哮喘患者69例设为A组;伴有变应性鼻炎的哮喘患者40例设为A+AR组;不伴有哮喘的变应性鼻炎...     

芪防鼻敏颗粒对变应性鼻炎大鼠炎性因子表达的影响研究

摘 要 目的：观察芪防鼻敏颗粒对变应性鼻炎（AR）大鼠血清白介素 4(IL 4),白介素 17(IL 17）,肿瘤坏死因子（TNF α）及鼻黏膜γ干扰素（IFN γ）、白介素 6（IL 6）、TNF α表达的影响。方法: SD大鼠随机分为正常组,模型组,氯雷他定组（1.17 mg·kg^-1）,鼻炎康组（0.6 g·kg^-1）,芪防鼻敏颗粒高（26.48 g·kg^-1）、中（13.24 g·kg^-1）、低（6.62 g·kg^-1）剂量组。采用卵蛋白（OVA）建立AR大鼠模型。造模成功后分别灌胃给药,连续14 d。酶联免疫吸附法（ELISA）检测AR大鼠血清IL 4、IL 17、TNF α水平,免疫组化染色法（IHC）检测鼻黏膜IFN γ、IL 6、TNF α表达。结果:与正常组相比,模型组大鼠血清IL 4、IL 17水平明显上升（P<0.01）;鼻黏膜IFN γ阳性表达明显降低（P<0.05）,IL 6、TNF α阳性表达显著升高（P<0.01）。与模型组相比,氯雷他定组、芪防鼻敏颗粒中剂量组大鼠血清IL 4水平显著下降（P<0.05）,芪防鼻敏颗粒低剂量组大鼠血清IL 17水平明显下降（P<0.05）,氯雷他定组、鼻炎康组、芪防鼻敏颗粒高、中剂量组大鼠血清TNF α水平显著下降（P<0.05或P<0.01）;高、低剂量组大鼠鼻黏膜IFN γ阳性表达显著升高（P<0.05或P<0.01）,高、中剂量组IL 6阳性表达显著降低（P<0.01）,高剂量组TNF α阳性表达显著降低（P<0.01）。与氯雷他定组相比,鼻炎康组、芪防鼻敏颗粒高剂量组大鼠血清IL 17水平明显上升（P<0.05）,鼻炎康组、芪防鼻敏颗粒低剂量组大鼠血清IL 4水平明显上升（P<0.05）,芪防鼻敏颗粒高、中、低剂量组TNF α阳性表达显著升高（P<0.05）;与鼻炎康组比较,芪防鼻敏颗粒中剂量组大鼠血清IL 4水平明显下降（P<0.05）;与芪防鼻敏颗粒低剂量组相比,芪防鼻敏颗粒高剂量组大鼠血清IL 17水平明显上升（P<0.05）,芪防鼻敏颗粒中剂量组大鼠血清IL 4水平明显下降（P<0.05）。结论:芪防鼻敏颗粒可增加AR鼻黏膜IFN γ表达,降低血清IL 4、TNF α、IL 17水平及鼻黏膜TNF α、IL 6表达。     

甲亢患者血清IgG、IgE测定的临床意义

目的探讨甲亢(Graves病,GD)患者治疗前后血清IgG、IgE的变化。方法70例GD患者治疗前后FT3、FT4、TSH、IgE采用化学发光免疫法测定,治疗前后IgG采用Beckman公司Array360特定蛋白分析仪测定。结果治疗后IgG、IgE较治疗前明显降低。结论GD患者血清IgG、IgE随病情好转、甲状腺功能正常而明显下降,提示血清IgG、IgE可作为GD患者疗效判断、停药的参考指标。     

Issues in Diisocyanate Antibody Testing

Diisocyanates are used to produce a wide variety of polyurethane products; they are also recognized as an important cause of occupational asthma. Their chemical reactivity presents challenges to toxicologists and clinicians alike seeking to understand the mechanisms underlying diisocyanate asthma. In this article, we review the literature on immunoassay detection of IgE and IgG binding to diisocyanate–protein conjugates and assess the utility of such testing as a diagnostic tool and exposure indicator. Data from 29 studies of occupational exposure to diisocyanates revealed considerable variability in assay methodology and heterogeneity in the prevalence of positive antibody responses across laboratories. In studies that included both confirmed diisocyanate asthma subjects and exposed nonasthmatics, positive IgE responses identified cases with low sensitivity (18–27%), but high specificity (96–98%). Detection of IgG binding to diisocyanate conjugates is an indirect, qualitative indicator of disease status and past diisocyanate exposure. The utility of these assays is limited, however, due to a lack of (1) method standardization, (2) population norms to guide interpretation of results, and (3) demonstration that the assays improve either on disease prediction or on exposure confirmation beyond that of other indicators. Sources of assay heterogeneity are discussed and suggestions are offered for improving test performance and interpretability.     

Inflammatory and immunological responses to subchronic exposure to endotoxin-contaminated metalworking fluid aerosols in F344 rats

Rats were exposed for 6 h per day in inhalation chambers to a 10 mg/m(3) concentration of metalworking fluid (MWF) contaminated with endotoxin at concentrations of 1813 (low dose) and 20,250 eu/m(3) (high dose) 5 days per week for 8 weeks. It was found that 94.7% of the MWF aerosol particles had diameters in the range of 0.42-4.6 microm, with geometric mean diameter of 1.56 microm. The body weight and pulmonary function parameters were measured every week during the 8 weeks of exposure, whereas bronchoalveolar lavage (BAL) fluid was prepared to measure the inflammatory markers and cytokines after the 8 weeks of exposure. There were no changes in body weight and respiratory function (tidal volume and respiratory frequency) during the 8 weeks of exposure to the MWF containing endotoxins, yet lung weight increased significantly (P < 0.05) in the rats exposed to the MWF both with and without endotoxins. The number of polymorphonuclear (PMN) cells in the BAL fluid increased significantly (P < 0.05) in the rats exposed to MWF with endotoxins, and the levels of cytokines such as IL-4, INF-gamma, IL-1beta, and TNF-alpha also were significantly increased (P < 0.05) compared to the control. The NOx production activity of the BAL cells increased significantly (P < 0.05) in the rats exposed to the MWF with and without endotoxins. Increases in lung weight, number of PMN cells, and levels of extracellular cytokines and NOx were all more significant in the rats exposed to the MWF with endotoxins rather than in those exposed to MWF without endotoxins. In spleen cell cultures, T-cell proliferation activity was decreased, yet cytokine levels (INF-gamma, IL-1beta, IL-4, and TNF-alpha) remained unchanged after repeated exposure to MWF with and without endotoxins. Although the levels of total IgG(1), IgG(2a), and IgE antibodies in the serum were not changed, the levels of endotoxin-specific antibodies, including IgG(2a) and IgE, were increased significantly (P < 0.05) in the rats exposed to endotoxins, but there was not a significant increase in endotoxin-specific IgG(1). When taken together, the results indicate that lung inflammatory responses can be induced without changing pulmonary function after repeated exposure to MWFs contaminated with endotoxins. In addition, endotoxin-specific IgG(2a) and IgE may be effective biomarkers for workers exposed to MWFs contaminated with endotoxins in the workplace.     

血清中变应原特异性IgE与支气管哮喘的关系

为分析支气管哮喘的发病原因，本文对４０例支气管哮喘患者采用荧光酶联免疫法（ｐｈａｒｍａｃｉａＣＡＰｓｙｓｔｅｍ），测定了血清中变应原特异性ＩｇＥ（ｓＩｇＥ）。结果发现主要变应原ｓＩｇＥ有四种，即２９例蒿草花粉ｓＩｇＥ（平均含量为３８．９０ｋＵ／Ｌ）、２３例户尘螨ｓＩｇＥ（１１．５４ｋＵ／Ｌ）、１４例屋尘ｓＩｇＥ（１．１０ｋＵ／Ｌ）、９例草花粉ｓＩｇＥ（１３．２８ｋＵ／Ｌ）阳性，由此可见，在我国北方地区引起季节性支气管哮喘的主要变应原为蒿草花粉，常年性发病的主要因素为户尘螨。     

Mast cells and basophils are essential for allergies: mechanisms of allergic inflammation and a proposed procedure for diagnosis

The current definition of allergy is a group of IgE-mediated diseases. However, a large portion of patients with clinical manifestations of allergies do not exhibit elevated serum levels of IgE (sIgEs). In this article, three key factors, ie soluble allergens, sIgEs and mast cells or basophils, representing the causative factors, messengers and primary effector cells in allergic inflammation, respectively, were discussed. Based on current knowledge on allergic diseases, we propose that allergic diseases are a group of diseases mediated through activated mast cells and/or basophils in sensitive individuals, and allergic diseases include four subgroups: (1) IgE dependent; (2) other immunoglobulin dependent; (3) non-immunoglobulin mediated; (4) mixture of the first three subgroups. According to our proposed definition, pseudo-allergic-reactions, in which mast cell or basophil activation is not mediated via IgE, or to a lesser extent via IgG or IgM, should be non-IgE-mediated allergic diseases. Specific allergen challenge tests (SACTs) are gold standard tests for diagnosing allergies in vivo, but risky. The identification of surface membrane activation markers of mast cells and basophils (CD203c, CCR3, CD63, etc) has led to development of the basophil activation test (BAT), an in vitro specific allergen challenge test (SACT). Based on currently available laboratory allergy tests, we here propose a laboratory examination procedure for allergy.     

Tanshinone IIA alleviates ovalbumin-induced allergic rhinitis symptoms by inhibiting Th2 cytokine production and mast cell histamine release in mice

ContextStudies have shown that tanshinone IIA (TIIA) has an anti-inflammatory effect, but the effect on allergic rhinitis (AR) is unclear.ObjectiveIn this study, we explore the effect of TIIA on AR.Materials and methodsAR mice model was established by the intraperitoneal (ip) injection of 50 μg ovalbumin (OVA). AR mice in the dose tested groups were treated with TIIA (10 mg/kg/d, ip) or dexamethasone (Dex) (2.5 mg/kg/d, oral). The number of nasal rubbing in mice was counted. Inflammatory, goblet and mast cells in nasal mucosal tissue were detected. The contents of histamine, OVA-immunoglobulin E (IgE), OVA-immunoglobulin G1 (IgG1), tumour necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-5, interferon-γ (IFN-γ) and IL-12 in nasal lavage fluid (NALF) or serum were measured. Human mast cells (HMC-1) were treated with C48/80 to release histamine or TIIA for therapeutic effect, and the cell viability, histamine content and mast cell degranulation were examined.ResultsOVA promoted the number of nasal rubbings in mice (78 times/10 min, p< 0.001), increased the inflammatory, goblet and mast cells in nasal mucosal tissue, and significantly (p< 0.001) elevated the levels of histamine (120 ng/mL), OVA-IgE (2 pg/mL), OVA-IgG1 (90 ng/mL), TNF-α (2.3 pg/mL), IL-4 (150 pg/mL) and IL-5 (65 pg/mL) in serum or NALF of OVA-induced AR mice. However, both TIIA and Dex inhibited the effect of OVA on AR mice. Besides, TIIA reversed the promotion of histamine release (30%) and mast cell degranulation induced by C48/80.Discussion and conclusionsTIIA alleviates OVA-induced AR symptoms in AR mice, and may be applied as a therapeutic drug for patients with Th2-, or mast cell-allergic disorders.     

Butyl benzyl phthalate: effects on immune responses to ovalbumin in mice

During recent decades the prevalence of IgE-mediated (atopic) allergic diseases in Western Europe and the USA has been increasing dramatically. It has been suggested that one possible cause is the presence in the environment of chemicals that may act as adjuvants, enhancing immune and allergic responses. Certain commonly used phthalate plasticizers such as butyl benzyl phthalate (BBP) have been implicated in this way. In the current experiments, the impact of BBP, applied by a physiologically relevant exposure route, on the vigour of immune responses induced in BALB/c strain mice has been examined. Mice were immunized via subcutaneous injection with the reference allergen ovalbumin (OVA) and received concurrent topical treatment with doses of BBP that induced significant changes in liver weight. The generation of specific anti-OVA IgE and IgG1 antibodies was measured by passive cutaneous anaphylaxis and by enzyme-linked immunosorbant assays, respectively. Topical administration of BBP was without impact on anti-OVA IgE antibody responses, regardless of whether BBP was applied locally or distant to the site of OVA immunization. However, same-site treatment with high-dose BBP (100 mg) did result in a modest elevation in anti-OVA IgG1 antibody production, a subclass of antibody used as a surrogate marker of IgE responses. Taken together with human exposure data, these results suggest that the doses of phthalate encountered in the home environment are unlikely to be a major factor contributing to the increased incidence of asthma and allergy in the developed world.     

ELISA检测特异性IgE在囊虫病免疫诊断中的初步应用

应用酶联免疫吸附试验(ELISA)间接法检测了35例囊虫病患者血清中特异性IgE和特异性IgG,并将两者间的阳性率进行了比较。同时,对25例华支睾吸虫病患者和26例肺吸虫病患者的血清进行了交叉反应试验。结果:35例囊虫病患者血清中特异性IgE和特异性IgG的阳性率分别为88.57％和91.43％(P>0.05),而正常献血员、华支睾吸虫病和肺吸虫病患者的血清无一出现阳性反应。     

血清霉菌特异性IgE阳性支气管哮喘患者的临床及过敏状态分析

目的探讨分析血清霉菌特异性IgE阳性支气管哮喘患者的临床及过敏状态。方法选取2010年1月至2013年1月在我院接受诊断和治疗的支气管哮喘患者70例为研究对象,抽取所有受试者的静脉血液,将血液样本进行常规离心(2000 r/min,10 min)处理后分离血清样本。使用固相酶斑点技术测定血清中霉菌过敏原特异性IgE。结果 70例患者中9例检测出霉菌,特异性IgE阳性率为12.86%;70例患者中在4¹0月中检出霉菌的为7例占17.07%,在1110月中检出霉菌的为7例占17.07%,在11³月份检出霉菌的为2例占6.90%,43月份检出霉菌的为2例占6.90%,4¹0月的检出率明显高于1110月的检出率明显高于11³月,P<0.05,差异统计学显著。结论霉菌是过敏性支气管哮喘的致敏原之一,并呈现季节性变化。血清霉菌特异性IgE的检测对临床诊断、治疗和预防支气管哮喘有重要意义,也为哮喘的流行病学提供了宝贵的实验室数据。     

禁食轮替疗法在慢性荨麻疹中的临床研究

目的：探讨禁食轮替疗法联合药物治疗由食物不耐受引起的慢性荨麻疹的近、远期疗效。方法：选取慢性荨麻疹食物特异性IgG抗体阳性病例60例,随机分为实验组30例与对照组30例,两组均采用扑尔敏4mg每天3次,西替利嗪1片每晚1次。实验组除与对照组相同的治疗外,加用禁食、轮替的方法,3个月后观察疗法疗效及不良反应,6个月后观察复发情况。结果：3个月后实验组痊愈率53.33%,高于对照组26.67%,两组比较差异有显著性（P＜0.05）。6个月后复发率实验组16.67%,对照组43.33%,两组比较差异有显著性（P＜0.05）,实验组患者的血清食物特异性IgG水平在治疗前后下降明显（P＜0.05）。结论：禁食轮替疗法可以有效减轻由食物过敏原特异性IgG引起的慢性荨麻疹患者的症状并降低不耐受食物的阳性率。     

安徽省1062例慢性荨麻疹过敏原检测结果分析

目的了解安徽省慢性荨麻疹患者的食人性与吸人性过敏原情况,为该病的预防和治疗提供依据。方法采用酶联免疫分析法,对1062例慢性荨麻疹患者进行吸入性过敏原和食人性过敏原特异性lgE抗体检测。结果1062例慢性荨麻疹患者过敏原阳性检出率为48．78％（518例）,吸入组过敏原的阳性率明显高于食人组,其中粉螨、尘螨（34．56％）、屋尘（10．73％）为主要过敏原。结论安徽省慢性荨麻疹患者吸人性过敏原的检出率明显高于食入性,过敏原以尘螨、粉螨和屋尘多见,找出致病因素对临床治疗慢性荨麻疹有较好的指导意义。