变应性鼻炎患者变应原皮试与血清特异性IgE检测的相关性研究

变应性鼻炎 (ＡＲ )的发生往往与环境中变应原有密切关系 ,找出变应原是ＡＲ诊断和治疗中的关键。对变应原的检测 ,近年来 ,采用体内变应原皮试和体外特异性ＩｇＥ检测 ,为进一步研究这两项检查的临床应用价值 ,本文对两者进行了相关分析 ,其结果如下 :1　材料和方法1 1　研究对象　诊断明确的常年性ＡＲ患者共 5 8例 ,男 30例 ,女 2 8例 ,年龄 12～ 5 5岁 ,病程 1～ 2 0年。对照组为 2 0例健康成人 ,男女各半 ,年龄 2 0～ 40岁。1 2　主要试剂　变应原浸液 :屋尘螨 (蛋白含量 1 5ｍｇ/ｍｌ)、法国梧桐花粉 (9ｍｇ/ｍｌ)、豚草花粉 (10ｍｇ/…     

上海地区儿童变应性鼻炎患者血清变应原检测分析

目的 分析上海地区儿童变应性鼻炎（AR）常见变应原分布情况,为其防治提供参考依据。方法 选取2021年1月-12月于复旦大学附属儿科医院就诊诊断为AR并进行体外血清过敏源特异性抗体（sIgE）检测的2762例患儿作为研究对象,比较不同性别、年龄、季节的AR患儿变应原阳性率。结果 上海地区2762例AR患儿中血清sIgE至少1种阳性者有2632例,阳性率为95.29%。在常见的29种变应原中,总体阳性率前5位的分别是牛奶64.27%（1775/2762）、户尘螨49.82%（1376/2762）、粉尘螨43.27%（1195/2762）、鸡蛋白34.00%（939/2762）、念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉28.39%（784/2762）。男性患儿对牛奶、粉尘螨、猫毛皮屑、狗毛皮屑、牛肉/羊肉变应原阳性率均高于女性患儿（P＜0.05）。在婴幼儿期,尘螨类、霉菌类变应原阳性率最低,此外不同年龄段牛奶、鸡蛋白、蟑螂、复叶槭/桑/洋槐/榆/柏/构树、小麦/荞麦、牛肉/羊肉、虾/蟹变应原阳性率比较,差异有统计学意义（P＜0.05）。夏季尘螨类变应原阳性最高,春季狗毛皮屑变应原阳性最高,植物类变应原阳性率高低与开花季节相一致。结论 上海地区AR患儿变应原阳性率最高的是牛奶和户尘螨,吸入性变应原阳性率随年龄的增加而上升,但食物性变应原与此相反,且尘螨类、植物类变应原阳性率随季节变化较显著。     

变应性鼻炎免疫治疗的研究进展

变应性鼻炎是一种由变应原激发并通过Ig E介导的鼻黏膜炎性疾病,因其反复发作的鼻部症状和并发症,给临床治疗带来很大挑战。免疫治疗是目前唯一能够改变变应性鼻炎自然病程、针对病因的治疗方法。近来,包括新的给药途径、变应原改造在内的各种新型免疫治疗方法大量涌现,给变应性鼻炎治疗提供更多有效和安全的选择。本文针对变应性鼻炎免疫治疗的最新研究进展进行综述,并对未来的方向进行展望。     

脱敏疗法治疗常年性变应性鼻炎的疗效观察

本文对76例常年性变应性鼻炎患者,分二组进行脱敏治疗,甲组用粉尘螨注射液,乙组用吸入物抗原。甲、乙两组在治疗前及治疗半年后记分别测定血清IgG、IgE。结果表明,甲、乙两组治疗前后记分比较均有非常显著性差异(P均<0.01)。两组间有效率无显著性差异(P>0.05)。两组在治疗前后血清IgG均有非常显著差异(P<0.01)。血清IgE也有显著差异(P<0.05)。血清IgG上升与IgE下降与临床症状好转相一致。甲组具有治疗方便,疗程短等优点。     

佛山乐从地区家具工人变应性鼻炎变应原检测分析

目的 分析佛山乐从地区家具工人变应性鼻炎变应原阳性分布情况.方法 收集2014年1月至2016年6月就诊于本院五官科的变应性鼻炎患者500例为观察组,职业均为家具工人;另选取同期本院就诊的非家具工人变应性鼻炎患者500例为对照组.进行患者血清总IgE水平与血清特异性变应原检测及变应原皮肤点刺试验,探讨两组患者吸入性变应原的阳性分布情况,分析两种变应原检测方法的一致性.结果 观察组和对照组患者血清总IgE阳性率分别为95.6％(478/500)、92.8％ (464/500),组间比较差异无统计学意义(x2=3.59,P＞0.05).血清特异性变应原检测和变应原皮肤点刺试验结果显示,两组患者螨类(粉尘螨、屋尘螨、热带螨)变应原阳性率均最高,且观察组螨类、德国小蠊、交链孢菌属、多主枝孢菌属、树木、杂草、霉菌变应原阳性率均显著高于对照组(均P＜0.05).两种变应原检测方法的一致性较好(均Kappa值＞0.6).结论 相对于非家具工人,家具工人变应性鼻炎的螨类等多种变应原阳性率均升高.     

变应性鼻炎患者血清IL-17和IL-23的表达及临床意义

目的:检测变应性鼻炎(Allergic rhinitis,AR)患者血清IL-17和IL-23的表达水平并探讨其临床意义。方法:检测25例AR患者(观察组)血清IL-17、IL-23、s Ig E(过敏原特异性Ig E)的表达水平,并以23名健康体检合格者(对照组)为对照,比较两组人群血清中IL-17、IL-23、s Ig E表达水平的差异,并探讨AR患者血清中IL-17、IL-23、s Ig E三者间的相互关系。结果:观察组患者血清中IL-17、IL-23及s Ig E水平均高于对照组(P均0.01);观察组患者血清中IL-17、IL-23、s Ig E三者两两之间均呈线性正相关关系(P均0.05)。结论:IL-17、IL-23参与了AR的发生发展过程,与s Ig E的形成可能有关。     

CCL趋化因子与变应性鼻炎

CCL趋化因子在嗜酸性细胞的募集中起着重要的作用,而嗜酸性细胞的募集是变应性鼻炎发生发展的关键.本文综述了CCL趋化因子中Eotaxin、RANTES和MCPs在变应性鼻炎发生中的作用.     

变应性鼻炎和哮喘的变应原皮试和脱敏治疗

对２００例变应性鼻炎、哮喘或二者兼有的病人进行变应原皮肤试验。发现上海地区７４％的上述病人中对２种或２种以上抗原过敏，其中除屋尘、尘螨是最常见的变应原外，对花粉、昆虫、真菌、羽毛等过敏也占相当比例。应用相应的变应原对病人进行脱敏治疗，其中５９例疗程大于６个多月，最长为２年半。结果显示脱敏治疗对变应性鼻炎和哮喘均有效。总有效率为８４．７％。鼻炎更好。凡疗程越长，效果越好。     

84例变应性鼻炎患儿过敏原皮内试验结果分析

目的 了解新疆地区变应性鼻炎患儿气传过敏原的分布状况,探讨气传变应原分布的地区差异及产生原因,为本地区儿童变应性鼻炎的防治方案提供客观依据.方法 采用阿罗格(NHD)点刺液进行皮肤点刺试验84例变应性鼻炎患儿进行气传变应原测试.结果 84例变应性鼻炎患儿吸入变应原测试总阳性率96.4%(81例),以藜属花粉最高70.2%(59例),蒿属植物次之42.9%(36例),其后依次为杨树27.4%(23例),榆树25.0%(21例),槭树17.8%(15例),柳树11.9%(10例),豚草(巨大豚草、普通豚草)11.9%(10例),粉螨10.7%(9例),尘螨9.5%(8例),交链孢霉8.3%(7例),特异青霉7.1%(6例),白色念珠菌4.8%(4例)等.81例对不同变应原过敏,其中42例(51.9%)患儿对2种或2种以上变应原过敏.点刺试验皮肤反应强度蒿属最明显,强阳性占蒿属过敏病人的50.0%,藜属次之,强阳性占藜属过敏病人的40.7%.结论 藜属和蒿属为新疆地区变应性鼻炎患儿最主要的变应原,在治疗过程中对这类变应性鼻炎患儿可采取有效的避、忌、替、移等措施,明确变应原后对特异性免疫治疗具有重要的指导意义.     

奥马珠单抗联合布地奈德对变应性鼻炎患者临床疗效及外周血Eos、IgE的影响

目的 探讨奥马珠单抗联合布地奈德治疗变应性鼻炎(allergic rhinitis,AR)患者临床疗效、外周血嗜酸性粒细胞(eosnphils,Eos)及免疫球蛋白E(immunoglobulin E,IgE)的影响.方法 选择2017年1月至2019年10月于我院诊断为AR的患者150例,按照随机表法分为两组,各75...     

CpG-ODN对婴幼儿喘息性支气管炎外周血单个核细胞T-bet表达的影响

目的：探讨CpG-ODN干预对婴幼儿喘息性支气管炎外周血单个核细胞（PBMC）T-bet表达和IFN-γ分泌的影响。方法：对28例喘息性支气管炎（喘支组）患儿于急性期和恢复期分别抽取抗凝静脉血并分离PBMC,以终浓度为10μg/ml的B型CpG-ODN刺激48小时,分别应用RT-PCR和Western blot检测CpG-ODN刺激前后患儿PBMC的T-bet mRNA和蛋白表达情况,以ELISA检测PBMC培养上清IFN-γ的变化,同时设立26例健康婴儿对照组。结果：与正常对照组比较,喘支患儿PBMC表达T-bet mRNA及蛋白明显减少（P〈0.05）,应用CpG-ODN刺激后,两组小儿PBMC表达T-bet均显著上调,但产生IFN-γ无明显增多,对照序列ODN对T-bet表达及IFN-γ的分泌无明显影响。相关分析表明,喘支患儿T-bet mRNA与IFN-γ分泌呈正相关（r=0.57,P〈0.01）,CpG-ODN刺激后,二者相关性明显下降（r=0.19,P〉0.05）。结论：T-bet在喘支患儿PB-MC中表达减少,提示T-bet表达缺陷参与了喘支的免疫病理,B型CpG-ODN作为一种免疫调节剂,可有效上调T-bet的表达,但不能诱导IFN-γ的产生。     

CpG-ODN对慢性乙型肝炎患者外周血单个核细胞T-bet表达的影响

目的 探讨T-bet在乙型肝炎病毒(HBV)感染中的作用以CpD-ODN对其表达的调节作用。方法应用半定量RT-PCR，对22例慢性乙型肝炎活动期患者、10例HBsAg阳性无症状携带者和12例正常对照外周血单个核细胞(PBMC)T-bet的表达进行检测；同时用CpD-ODN体外刺激以上3组实验对象的PBMC，RT-PCR观察T-bet的表达情况。结果无症状携带者T-bet表达最低，慢性乙型肝炎活动期患者T-bet表达最高；经cpG-ODN刺激后，无症状携带者和正常对照的T-bet表达明显上调，结论T-bet在HBV感染的不同状态中具有差异表达，提示T-bet可能参与了机体抗HBV的免疫应答，具体的机制有待进一步研究。CpG-ODN作为一种新型的免疫调节剂，可在一定程度上恢复HBV感染者特别是无症状携带者的Th1型细胞免疫应答．     

Clinical value of serum IL-27 in allergic rhinitis patients and its relationship with Treg associated cytokine levels

Allergic rhinitis (AR) is a nasal allergic disease mainly mediated by IgE, and the immune response is the pathological basis of AR pathogenesis. Regulatory T cells (Treg) has been confirmed to be involved in the occurrence of AR. IL-27 mediates inflammatory responses and allergic symptoms in AR by promoting Tregs and related factors. Our study aimed to explore the correlation between serum interleukin 27 (IL-27) and Treg associated cytokines in the pathogenesis of AR. Based on the inclusion and exclusion criteria, 69 participants with AR and 50 healthy participants were selected. Their IL-27, IL-10, and TGF-β1 levels were estimated by ELISA. Receiver operating characteristics curve (ROC) was performed to demonstrate the diagnostic efficiency of IL-27 in AR. Pearson correlation analysis was used for correlation analysis. IL-27 in AR patients statistically decreased compared to the control group. Consistently, IL-27 were also negatively correlated with the clinical severity of AR patients. Treg related cytokines including IL-10 and TGF-β1 in AR patients was statistically decreased. In addition, the IL-10 and TGF-β1expressions were positively correlated with IL-27 in AR patients. IL-27 was statistically down-regulated in patients with AR, which is related to insufficient Treg function. Restoring the expression of IL-27 may become a novel approach to treat AR.     

Specific IgE serum concentration is associated with symptom severity in children with seasonal allergic rhinitis

Background: The impact of allergen‐specific and total IgE serum levels before and during the pollen season on symptom severity as well as efficacy of treatment with anti‐IgE requires further delineation. Methods: Birch and grass pollen allergic patients aged 6–17 years with seasonal allergic rhinitis (SAR) were analyzed for the association of IgE serum concentration with symptom severity and rescue medication use (combination: symptom load, SL) during the grass pollen season. Reference group A (n = 53) received placebo, while group B (n = 54) received Omalizumab (anti‐IgE) monotherapy before and during the grass pollen season. Results: Patients on placebo with high baseline specific grass pollen IgE (>50 kU/l) had a significantly higher SL compared with those with low IgE levels (≤50 kU/l): SL 1.28 vs 0.61, P = 0.015. This association was nonexistent in patients treated with anti‐IgE. In contrast, baseline total IgE levels did not correlate with SL in any group. Patients with anti‐IgE treatment and high free total IgE levels (>16.7 ng/ml) had a significantly higher SL compared with those with low free total IgE levels (≤16.7 ng/ml): SL 0.63 vs 0.23, P = 0.031. Conclusions: Baseline specific IgE, but not total IgE, is associated with symptom severity during the pollen season in children with SAR. Likewise, the symptom load in SAR patients with anti‐IgE correlates with free total IgE levels. Although further research in larger populations is needed to confirm our findings, our data suggest that specific IgE can be used as a parameter for patient selection for this kind of treatment.     

Bronchial hyperresponsiveness in young children with allergic rhinitis and its risk factors

BACKGROUND: Subjects with allergic rhinitis but no clinical evidence of asthma have greater bronchial hyperresponsiveness (BHR), and several factors have been implicated as its determinants. However, studies in young children are lacking. The aims of this study were to evaluate the prevalence of BHR in young children with allergic rhinitis and to investigate its risk factors. METHODS: Methacholine bronchial challenges were performed in 4- to 6-year-old nonasthmatic children with allergic rhinitis (n = 83) and in healthy nonatopic controls (n = 32), using a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Subjects were considered to have BHR when they had end-point concentrations of methacholine 相似文献