116例变应性皮肤病患儿血清特异性IgE及总IgE检测分析

目的:了解小儿荨麻疹和遗传过敏性皮炎(AD)患者血清特异性 IgE(SIgE)及总IgE(TIgE)水平变化。方法:采用Mast检测系统,对116例变态反应性皮肤病患儿血清SIgE和TIgE进行检测。结果:荨麻疹和AD患儿均以屋尘螨、粉尘螨阳性检出率最高,分别为荨麻疹(20.5％、17.9％)和AD(34.2％、34.2％)。在AD患儿,家尘、狗毛、猫毛、牛奶、鸡蛋亦有较高的阳性检出率。结论:屋尘螨、粉尘螨是广州地区小儿荨麻疹和AD患者最常见的变应原。     

三种变态反应性皮肤病患者血清IgE抗体检测和分析

目的：对三种常见的变态反应性皮肤病患者的血清进行过敏原特异性IgE抗体和总IgE检测，了解佛山地区这三种皮肤病的过敏原状况，供临床治疗作参考。方法：采用酶联免疫分析法对83例慢性荨麻疹、35例慢性湿疹、21例特应性皮炎、20例体检人员进行过敏原检测（IVT729、IVT730）。结果：三种变态反应性皮肤病总IgE检测阳性率为94．24％；各种主要过敏原：慢性荨麻疹：鱼48．19％、霉菌27．71％、菇类25．30％、屋尘、尘螨22．89％、猫、狗、羊、兔毛、虾、蟹均是16．87％；慢性湿疹：鱼40．00％、霉菌、菇类、蛋均是22．86％、蟑螂、飞蛾17．14％、屋尘、尘螨和榕树、桑树均是11．43％、猫、狗、羊、兔毛、虾、蟹均是5．7l％；特应性皮炎：霉菌28．57％、屋尘、尘螨23．81％、鱼、榕树、桑树均是19．05％、松树、白桦树、猫、狗、羊、兔毛、虾、蟹均是9．52％。结论：在佛山地区，过敏原对这三种变态反应性皮肤病有着重要影响，特别是鱼、菇类、霉菌、屋尘、尘螨。     

130例慢性荨麻疹皮试及血清总IgE含量检测分析

为了探讨温州地区慢性荨麻疹的发病主要致敏原与发病机制，我们对130例慢性荨麻疹病人进行抗原皮试和血清总IgE含量测定。现将结果报告如下。     

慢性荨麻疹患者血清特异性IgE及甲状腺自身抗体的检测

目的：探讨自身免疫在特发性慢性荨麻疹和已知特异性过敏原慢性荨麻疹发病机制中的作用。方法：采用敏筛过敏原检测系统和放射免疫法，对120例慢性荨麻疹患进行血清特异性I姬及甲状腺自身抗体的检测。结果：86例血清特异性IgE阳性的慢性荨麻疹患中，23例(26．7％)甲状腺过氧化物酶抗体(TPOAb)阳性；18例(20．9％)促甲状腺受体自身抗体(TRAb)阳性。34例血清特异性IgE阴性的慢性荨麻疹患中，10例(29．4％)TPOAb阳性；8例(23．5％)TRAb阳性。两组慢性荨麻疹的TPOAb及TRAb均显高于正常对照组(P均＜0．01)；但两组之间的TPOAb及TRAb阳性率比较，均无显性差异(P均＞0．05)。结论：部分特发性慢性荨麻疹和已知特异性过敏原慢性荨麻疹的发病均可能有自身免疫机制参与。     

过敏性皮肤病患者血清吸入性过敏原特异性IgE研究

为了了解吸入性过敏原在过敏性皮肤病中的作用，采用酶联免疫吸附试验检测148例荨麻疹，138例湿疹和49例异位性皮炎血清屋尘，尘螨，霉菌，豚草花粉，艾蒿花粉，树花粉等6种常见吸入性过敏原特异IgE。结果显示70．9％荨麻疹，79．0％湿疹和77．6％异位性皮炎患者血清中至少有一种吸入性过敏原特异IgE为阳性，均显著高于健康对照组13．0％的阳性率（P＜0．01），有异位性病史的异位性皮炎患者血清吸入性过敏原特异IgE的阳性率为90．3％，显著高于无异位性病史者的阳性率58．3％（P＜0．05），提示吸入性过敏原诱发的I型变态反应在荨麻疹，湿疹和异位性皮炎的发病中起了一定作用，并且有异位性病史的异位性皮炎患者比无异位性病史的患者对吸入性过敏原敏感。     

慢性荨麻疹患者特异性IgE检测及过敏原筛查分析

为了解广州地区慢性荨麻疹与过敏原之间的关系。采用过敏原体外检测试剂盒对慢性荨麻疹患者血清特异性IgE进行检测，并对过敏原的种类进行分析。结果：广州地区慢性荨麻疹患者在食物组中主要对螃蟹、虾（66．88％）和鳕鱼、带鱼、金枪鱼（62．42％）过敏，在吸入组中主要对尘螨、粉螨（64．97％）和点青霉、交链孢霉（62．42％）过敏，慢性荨麻疹患者对3种（36．94％）或4种（26．75％）过敏原同时过敏所占的比例最高。慢性荨麻疹患者往往对多种过敏原同时过敏，过敏原类别与当地的生活环境与饮食结构等因素密切相关。     

慢性荨麻疹患者变应原检测及疗效观察

利用定量过敏原检测系统检测80例慢性荨麻疹患者变应原及治疗前、后的血清总IgE水平.结果:慢性荨麻疹患者的变应原检测阳性率为71.25%,以吸入性变应原为主(74.2%),明显高于食入性变应原25.8%(P<0.05);吸入性变应原中尘螨所占比例最高,其次是猫、狗毛皮屑,蟑螂等.用卡介菌多糖核酸联合西替利嗪治疗6周后治疗组患者的有效率为92.5%,明显高于对照组72.5%(P<0.05),且总IgE水平显著下降并低于对照组(均P<0.01).     

慢性湿疹、荨麻疹患者血清过敏原特异性IgE的检测

慢性湿疹、慢性荨麻疹由于病因复杂，因而治疗效果往往不佳。我们对确诊的72例慢性湿疹、141例慢性荨麻疹患者进行了血清过敏原特异性IgE检测，并与50例正常人对照．现将结果报道如下。     

慢性自发性荨麻疹患者血清特异性IgE抗体与自体血清皮肤试验的关系

目的：比较慢性自发性荨麻疹(CSU)患者血清特异性IgE抗体检测结果与自体血清皮肤试验(ASST)的关系,探讨ASST的临床意义。方法：对305例慢性自发性荨麻疹患者同时进行血清特异性IgE抗体检测及自体血清皮肤试验(ASST),对两组的阳性率进行统计分析。结果：305例CSU患者螨虫组合(屋尘螨/粉尘螨)血清特异性IgE抗体与ASST总阳性率分别为47.87%和58.03%,ASST阳性组和阴性组中螨虫组合血清特异性IgE抗体阳性率分别为34.46%和66.41%,两组差异有统计学意义(P<0.05)。ASST阳性程度与对应螨虫、屋尘、狗、大豆、虾血清特异性IgE抗体检测水平呈负相关性(P<0.05)。结论：CSU患者部分常见变应原血清特异性IgE抗体与自体血清皮肤试验结果呈负相关,建议将ASST纳入常规CSU临床检测,ASST阳性的患者可以不进行血清特异性IgE抗体检测。     

257例儿童荨麻疹血清特异性过敏原IgE检测结果分析

目的:探寻荨麻疹患儿常见的过敏原种类,为其治疗及预防提供依据.方法:采用Mediwiss 公司AllergyScreenAnalytic GmbH 过敏原检测系统,对257 例荨麻疹患儿进行血清特异性IgE(specific IgE,sIgE)和总IgE 检测,并在不同年龄组间进行比较.结果:257例荨麻疹患儿sIgE阳性142例(55.27%),总IgE阳性率69.65%.其中吸入性过敏原最常见的依次为户尘螨18.68%、霉菌组合17.51%、猫毛皮屑4.67%、屋尘4.28%和狗毛皮屑3.89%;食物性过敏原中,最常见的依次为牛奶28.79%、羊肉16.34%、牛肉7.00%、鸡蛋白5.45%和虾3.11%.比较＜3 岁组、3～6 岁组和＞6 岁组,户尘螨、猫毛皮屑、牛奶和羊肉sIgE阳性率的差异有统计学意义(P ＜ 0.05).结论:尘螨和霉菌是荨麻疹患儿最主要的吸入性过敏原,牛奶、牛羊肉、鸡蛋白是荨麻疹患儿最常见的食物性过敏原.血清sIgE检测为荨麻疹患儿提示了相关过敏原,可以针对性地回避相关过敏原.     

Correlation among skin prick test, total and specific IgE UniCAP tests in atopic patients from Zagreb, Croatia

The correlation of pollen allergens, Dermatophagoides pteronyssinus and animal dender was assessed during a two-year period. Results of skin prick test, total and specific IgE UniCAP tests were compared in atopic patients (AP) with the following diagnoses: atopic dermatitis, allergic rhinitis, allergic conjunctivitis, allergic bronchitis or asthma, allergic urticaria and angioedema. The study included total and specific IgE (in vitro) tests to allergen mixtures (grass, tree, weed) or to single allergens of Dermatophagoides pteronyssinus (Der p), cat and dog fur, feather, etc. Comparison of skin prick test with total and specific IgE UniCAP immunoassay was done in 173 patients, i.e. 107 female and 66 male atopic patients aged 9-76 years. Allergies were most commonly recorded in the 25-35 age group. Total IgE ranged from 8.63 kU/l to >4000 kU/l, with specific IgE ranging from class 1 to class 5. Skin prick test showed high correlation with specific IgE for grass and weed pollen in patients with repiratory allergy (50.28%). Good correlation among all three tests was quite frequently observed. The results suggest that the study should be continued using these three tests in further cases of atopic dermatitis.     

Total IgE levels in the serum in dermatologic diseases

A total of 2,951 determinations of total IgE serum levels in dermatologic patients revealed significantly elevated geometric mean values in 18 of 25 diagnostic groups. The highest IgE concentrations (geometric mean greater than 100 kU/l) were found in atopic diseases (atopic eczema, extrinsic asthma, allergic rhinitis), scabies, ichthyosis vulgaris and diseases of the prurigo group. Furthermore, total IgE was elevated in acute, chronic, and physical urticaria, in patients with immediate-type allergies, in various kinds of eczema, in patients with characteristic features of atopy (typus atopicus), in psoriasis, in pyogenic skin infections, and alopecia areata. The range of individual IgE values was wide: in all diagnostic groups individual IgE levels beneath the normal adult geometric mean of 14 kU/l were found; the maximum concentrations were 340-47,000 kU/l, thus exceeding the upper limit of 100 kU/l for individual values. Knowledge of the patient's clinical condition is a prerequisite for the diagnostic interpretation of an individual total IgE serum level.     

The sweat of patients with atopic dermatitis contains specific IgE antibodies to inhalant allergens

We have investigated levels of total and specific against inhalant allergens in the sweat of 15 patients with atopic dermatitis, 10 patients with allergic rhinitis and high levels of specific IgE in the serum, and five patients with psoriasis without atopy as controls, by means of various commercial methods such as fluorescence immunoassay, nephetometry, chemiluminescence assay, enzyme immunoassay and the radioallergosorbent lest. Total IgE and specific IgE antibodies were detectable in the sweat of patients with atopic dermatitis as well as of patients with allergic rhinitis alone. These levels of total IgE in the sweat correlated with the severity of the skin disease (P < 0·05). By means of the Ciba Corning assay (P < 0·001), the fluorescence immunoassay (P < 0·05) and the nephelometry assay (P < 0·05), positive correlations were then established between the levels of total IgE in the serum and the sweat. Moreover, specific IgE antibodies to birch pollen and Dermatophagoides pteronyssinus were detectable in the sweat and correlated positively with these specific IgE levels in the serum (P < 0·05). Further, the specific IgE levels against these allergens in the sweat also correlated with the severity of dermatitis (P < 0·05). It is suggested that these specific IgE antibodies against certain inhalant allergens in the sweat of patients with atopic dermatitis may play a role in allergen trapping in the skin.     

Atopy patch test reaction to airborne allergens in the diagnosis of atopic dermatitis

The aim of the study was to evaluate the possible use of atopy patch test in the diagnosis of atopic dermatitis and to characterize an optimal standardized system for atopy patch test in terms of allergen concentrations and time of allergen exposure. The study included 36 patients with atopic dermatitis and IgE-mediated airborne allergy. Patients presented positive results of skin prick tests and serum antigen specific IgE against house dust mite allergens and/or selected grass pollen allergens. Control groups consisted either of patients with allergic rhinitis (control group 1) or healthy volunteers with no signs or symptoms of atopy (control group 2). Allergologic diagnostic workup consisted of skin prick test, serum antigen specific IgE and total IgE evaluation, atopy patch test with selected airborne allergens of different concentrations (0.1xSPT, 1xSPT and 10xSPT), time of allergen exposure (8, 24 and 48 h), and readings of the results (8, 24, 48 and 72 h). Positive results of atopy patch test with airborne allergens were obtained in 47.2% of atopic dermatitis patients and none of control subjects. Contact reaction itself and the intensity of reaction were demonstrated to correlate with allergen concentration and time of allergen exposure on atopy patch test. The dose and time response analysis showed the optimal concentration of allergens for atopy patch test to be 10xSPT, 500000 SBE/ml, and optimal evaluation time 24 and 48 h of allergen application. There was no correlation between atopy patch test results and mean serum concentrations of total or antigen specific IgE. Atopy patch test results did not correlate with localization of skin lesions, severity and extensiveness of skin inflammation. A significantly higher contact reactivity to airborne allergens was recorded in the group of atopic dermatitis patients with polyvalent allergy in comparison with atopic dermatitis patients allergic to only one aeroallergen. It is concluded that atopy patch test is the only provocation test currently available with clinical relevance for contact IgE-mediated sensitization in atopic dermatitis patients. Using petrolatum as a vehicle, allergen concentration of 500000 SBE/ml and evaluation time of 24 and 48 h of allergen application may lead to improved atopy patch test results.     

A study on serum IgE and clinical symptomatology of atopy in patients suffering from the lysosomal storage disorder Fabry disease

Background Lysosomal storage disorders may impair intracellular lysosomal processing of antigen with consequences for antibody production [e.g. immunoglobulin E (IgE)] and atopic disease status. Aims Serum concentration of total IgE as well as clinical symptoms of atopic disorders as an indirect consequence of lysosomal impairment of antigen processing were studied in male and female Fabry disease (FD) patients with and without replacement of the missing lysosomal enzyme, α‐galactosidase A (α‐Gal A). Methods Observational study in 31 adult FD patients with measurements of total serum IgE concentration. Questionnaire‐derived data were obtained for atopic eczema (AE) skin lesions, allergic rhinoconjunctivitis (RCA) and allergic asthma (AA) at present or in the past. Results Among 12 FD males under enzyme replacement therapy (ERT), 2 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 2, RCA and AE in 1, respectively. Among 10 FD females under ERT, 4 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 4, RCA in 2 and AE in 2. Among 9 females without ERT, 2 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 2, RCA in 2 and AE in none. Conclusions FD patients may demonstrate an increased total serum IgE concentration and may show symptoms of atopic disorders (AA, RCA, AE) in a prevalence rate comparable to international experience for individuals without FD. There was no difference between patients with and without ERT. Lack of detection of AE in females without ERT is suggested to be caused by the small sample size. FD patients without any α‐Gal A activity prior to initiation of ERT should be in the focus of future studies.     

Atopic disease and serum immunoglobulin-E

Fifty-seven subjects, forty-three with various combinations of atopic disease and fourteen non-atopic controls, were studied using a battery of immediate skin test allergens and a radio-immunoassay for serum Immunoglobulin-E (IgE). The geometric mean serum IgE level (units/ml) was 50 in strictly nonatopic controls, 170 in atopic respiratory disease (ARD) patients, 320 in atopic dermatitis (AD) patients and 772 in those patients with both AD-ARD. The marked elevation of the serum IgE in the latter group was not associated with respiratory disease activity and not closely correlated with extent of the dermatitis, but may relate to patients with both AD-ARD being 'highly atopic'. Overall, there was no correlation between the serum IgE level and the frequency of positive skin tests. Compared to ARD patients, the serum of AD patients contained more IgE, yet they reacted significantly less frequently to common extrinsic allergens.     

变态反应性皮肤病患者血清过敏原及IgE检测分析

目的了解临床上常见的变态反应性皮肤病的特异过敏原及血清总IgE水平变化.方法采用荧光酶标法(MAST法)检测了987例变态反应性皮肤病患者的过敏原血清特异性IgE(sIgE)和总IgE水平.结果sIgE阳性率为73.4%(724/987),总IgE阳性率为86.6%(855/987).其中粉尘螨、屋尘螨、霉菌类、狗毛占多数,食物类过敏以虾、蟹为主.结论MAST CLA-1测定仪应用荧光酶标法的原理检测过敏原操作简单,特异性高,特异性过敏原的检测对变态反应性皮肤病的预防和治疗有一定的指导作用.     

Analysis of MAST-CLA Results as a Diagnostic Tool in Allergic Skin Diseases

Background

Urticaria and atopic dermatitis are representative allergic skin diseases that can be mediated by IgE. Measuring levels of specific IgE can be used to confirm causative agents of these skin diseases.

Objective

To analyze results from the multiple allergosorbent test chemiluminescent assay (MAST-CLA), which measures specific IgE in the presence of a causative agent/allergen, in IgE-mediated skin diseases.

Methods

A total of 404 patients with urticaria, atopic dermatitis or pruritus were enrolled in the present study. Positive rates of specific IgE as well as total serum IgE from the MAST-CLA were compared.

Results

Positive rates of specific IgE were highest in atopic dermatitis patients, followed by urticaria, and then pruritus, with 57.0%, 37.1%, and 20.8%, respectively (p<0.05). House dust mite species were the most common allergens in both atopic dermatitis and urticaria skin diseases. There were no differences in the overall MAST-CLA results between acute and chronic urticaria. The relative positive rate of inhalant allergen was significantly higher in adult than in child atopic dermatitis patients.

Conclusion

Results from the MAST-CLA showed diversity among the three disease groups, and within each disease group, with different positive rates of specific IgE, a different mean allergen number per patient, and so on. Therefore, we concluded that MAST-CLA could be a useful diagnostic tool for various allergic skin diseases.     

IgE antibodies to Pityrosporum ovale in atopic dermatitis

An enzyme-linked immunosorbent assay (ELISA) was developed to assess serum IgE antibodies directed against Pityrosporum ovale in patients with atopic dermatitis (AD), atopic patients with allergic respiratory disease (ARD: rhinitis or asthma) but without eczema, and in healthy controls. IgE binding to P. ovale extract was demonstrated in 49% (35/72) of AD patients. In contrast, anti-P. ovale IgE was found in only one of 27 atopic controls without eczema; all healthy control sera (n = 17) were negative. Of 37 AD patients tested intracutaneously with P. ovale, 31 showed immediate-type reactivity, and 20 of these 31 patients had anti-P. ovale IgE detectable by ELISA, while sera from the six non-responders were all negative. Levels of anti-P. ovale IgE were highest in AD patients aged 20-30 years. No correlation was found with the severity of AD, but there was a non-significant tendency (P = 0.06) to higher levels in AD patients with concomittant respiratory allergy. Anti-P. ovale IgE was significantly correlated with total serum IgE, with specific IgE against various aeroallergens as measured by RAST, and with levels of anti-Candida albicans IgE, measured with a similar ELISA. Thus, production of IgE antibodies against P. ovale occurs very frequently in AD, and rarely in patients with atopic disease without skin involvement.     

Radioimmunologic determination of total IgE and allergen-specific IgE-antibodies in diffuse neurodermitis]

Total IgE levels in sera of 165 patients with atopic dermatitis and 79 patients with dermatoses as well as normal control patients were determined by radioimmunoassay (Phadebas, Pharmacia). Although the mean value for patients with atopic dermatitis was found far above the mean value for normal controls, 38% of patients showed total IgE serum levels within the normal range. Highest IgE serum levels were observed in patients with the generalized form of the disease and in patients with asthma and allergic rhinitis. No direct correlation however, to severity of disease could be found. In a series of 50 patients prick tests were compared to total IgE serum levels and to levels of allergen specific antibodies determined by radioallergosorbent-test (RAST). Extracts of grass pollens and of animal dandruff were used. There was complete agreement between results of skin testing and RAST in at least 80%. While cross reactions were common with grass pollen extracts in RAST, there was no cross-over with animal dandruff. No correlation was found between titer of allergen specific antibody and severity of skin lesions. IgE specific antibody could be detected in 48% of patients with normal total IgE serum levels and in 82% of patients with elevated values.