支气管哮喘与过敏性鼻炎患者对蟑螂变应原特异性IgE反应的对比研究

为比较支气管哮喘与过敏性鼻炎患者对不同种属蟑螂的过敏反应程度,探讨不同种属蟑螂间可能存在的交叉抗原性及其程度,用ELISA法检测支气管哮喘与过敏性鼻炎患者血清中对三种蟑螂(美洲大蠊、黑胸大蠊和德国小蠊)变应原的特异性IgE抗体(sIgE).结果显示支气管哮喘患者对美洲大蠊、黑胸大蠊和德国小蠊变应原的sIgE阳性率分别为23.5%、16.0%和14.0%,美洲大蠊sIgE阳性率比对德国小蠊为高,有显著性差异(P=0.015),虽然美洲大蠊sIgE阳性率比对黑胸大蠊高、黑胸大蠊sIgE阳性率比对德国小蠊高,但差异均无统计学意义(P=0.060;P=0.575);哮喘患者中美洲大蠊与黑胸大蠊sIgE反应符合率74.0%,美洲大蠊与德国小蠊sIgE反应符合率73.5%,黑胸大蠊与德国小蠊sIgE反应符合率85.0%.过敏性鼻炎患者对美洲大蠊、黑胸大蠊和德国小蠊sIgE阳性率分别为24.8%、17.6%和15.8%,美洲大蠊sIgE阳性率比对德国小蠊高,有显著性差异(P=0.040),虽然美洲大蠊sIgE阳性率比对黑胸大蠊高、黑胸大蠊sIgE阳性率比对德国小蠊高,但差异均无统计学意义(P=0.106,P=0.658);过敏性鼻炎患者对中美洲大蠊与黑胸大蠊sIgE反应符合率为73.9%,对美洲大蠊与德国小蠊sIgE反应符合率为75.2%,对黑胸大蠊与德国小蠊sIgE反应符合率为86.1%.过敏性鼻炎患者对美洲大蠊、黑胸大蠊和德国小蠊sIgE阳性率均比支气管哮喘患者高,但差异均无统计学意义(P=0.764;P=0.688;P=0.638).提示支气管哮喘与过敏性鼻炎患者对三种蟑螂的过敏反应程度基本相当,三种蟑螂间可能存在一定程度的交叉抗原性成分.     

检测变应性疾病患者特异性IgE探讨三种蟑螂的交叉抗原性

用ELISA法检测变应性疾病患者血清中对三种常见蟑螂:美洲大蠊、黑胸大蠊和德国小蠊变应原的特异性IgE抗体(sIgE),以探讨它们之间可能存在的交叉抗原性及其程度。结果美洲大蠊、黑胸大蠊和德国小蠊sIgE阳性率分别为24.1%、16.7%和14.8%。美洲大蠊与黑胸大蠊间血清学反应符合率为74.5%,美洲大蠊与德国小蠊间血清学反应符合率74.2%,黑胸大蠊与德国小蠊间血清学反应符合率为85.5%。美洲大蠊头部和体部sIgE阳性率分别为17.3%和13.4%;黑胸大蠊头部和体部sIgE阳性率分别为12.1%和9.6%。美洲大蠊头部抗原与其体部抗原间血清学反应符合率为82.5%;黑胸大蠊头部抗原与其体部抗原间血清学反应符合率为88.2%;ELISA交叉抑制实验结果显示,三种蟑螂相互之间均存在较明显的交叉抑制现象。表明三种蟑螂间及美洲大蠊、黑胸大蠊不同部位之间均存在一定程度的交叉抗原性成分,即具有共同的IgE结合组分。     

黑胸大蠊体部和粪中变应原的交叉性及与哮喘的关系

目的 :探讨黑胸大蠊体部浸液 (WBE)和粪浸液 (FE)的变应原交叉性及与哮喘的关系。方法 :支气管哮喘患者和健康人各 30例 ,分别以WBE和FE作人嗜碱粒细胞脱颗粒试验 (HBDT)、ELISA进行比较。采用SDS PAGE和免疫印迹试验分析和确定变应原的组分 ,进而用ELISA和免疫印迹抑制试验观察WBE和FE的交叉性。结果 :①哮喘组HBDT和sIgE的阳性率均明显高于健康组 (P <0 0 5 ) ;②SDS PAGE显示 ,WBE至少有 30条可分辨的蛋白条带 ,而FE有 15条蛋白带 ,至少有 8条(97 4kD、79 5kD、72kD、6 6kD、4 3kD、4 1kD、36kD、2 4kD)与WBE处于相同的位置 ,免疫印迹试验显示 ,9例sIgE呈阳性的哮喘患者中 88 9% (8/ 9)出现阳性条带 ,其中 72kD、36kD较常见 ;③将WBE或FE预先与阳性血清作用后可抑制阳性血清的ELISA和免疫印迹试验的阳性反应。结论 :黑胸大蠊的体部和粪便中具有相似的变应原性 ,与哮喘的发病有关 ;其主要变应原组分为 72kD、36kD。     

儿童特应性皮炎血清特异性IgE和斑贴试验结果的临床分析

目的:回顾性分析广州地区特应性皮炎(AD)患儿常见变应原,为AD预防和诊治提供依据.方法:ELISA检测138例AD患儿血清特异性IgE(sIgE),并分析其吸入组、食入组变应原;其中43例患儿同时接受了用于检测日常接触类变应原的皮肤斑贴试验,分析其结果分布特征.结果:吸入性特异性总IgE抗体检测结果阳性率为57.97...     

广州地区呼吸道疾病患儿16种常见变应原检测分析

目的 了解广州地区呼吸道疾病患儿对16种常见变应原的过敏情况,同时探讨不同年龄组之间的变应原阳性率差异,并比较致敏程度.方法 选择2007年8月至2008年3月广州医学院第一附属医院呼吸科门诊和儿科门诊初诊为支气管哮喘、过敏性鼻炎、呼吸道感染等患儿320例为研究对象,其中婴幼儿组(≤3岁)214例,儿童组(>3岁)106例.采用德国FOOKE ALLERG-O-LIQ-SYSTEM变应原检测系统,通过免疫捕获法检测血清中常见的16种变应原特异性免疫球蛋白E(SIgE)抗体.结果 在所有患儿中,其中261例(81.56%)SIgE呈阳性.59例(18.44%)呈阴性.16种变应原SIgE阳性率为屋尘螨(36.88%)、粉尘螨(35.31%)、热带螨(24.06%)、狗毛(6.56%)、猫毛(8.75%)、德国小蠊(16.56%)、蜜蜂毒素(0.94%)、屋尘(45.63%)、全蛋(45.94%)、牛奶(46.25%)、小麦面粉(6.88%)、玉米粉(1.25%)、花生(9.06%)、大豆(5.94%)、螃蟹(2.81%)、虾(4.38%).婴幼儿组SIgE的阳性率为81.78%,以食物性变应原(牛奶、全蛋)为主;儿童组的阳性率为81.13%,以吸人性变应原(尘螨)为主(X2=0.02,P=0.89).儿童组尘螨的过敏阳性率均高于婴幼儿组(P<0.05),且儿童组屋尘螨和粉尘螨的过敏程度多在3级以上.婴幼儿组各级阳性率比较平均.两组对热带螨的过敏程度均较低,多在3级以下.婴幼儿组牛奶和全蛋过敏阳性率高于儿童组(P<0.05),两组的过敏程度均在3级以下.结论 儿童组与婴幼儿组对常见变应原的总阳性率差异无统计学意义,只是对不同变应原阳性率及过敏程度的差异.儿童组主要是对吸人性变应原产生过敏,婴幼儿组主要是对食物性变应原产生过敏,应以不同年龄段来分析儿童变应原检测结果.     

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.     

BSA-ELISA初步检测短穗鱼尾葵花粉特异性IgE

目的对短穗鱼尾葵花粉粗浸液的主要变应原进行分析、鉴定。方法通过SDS-PAGE分析短穗鱼尾葵花粉蛋白质组份,采用Western blotting鉴定主要变应原,以短穗鱼尾葵花粉粗浸液包板,摸索出其包被浓度、血清稀释度和酶结合物浓度,采用BSA-ELISA法对短穗鱼尾葵花粉过敏患者血清进行初步检测,并与皮肤挑刺试验比较。结果短穗鱼尾葵花粉粗浸液SDS-PAGE显示有30余条蛋白条带,其中主要蛋白条带有10条,Western blotting显示5例短穗鱼尾葵花粉过敏患者的混合血清能与其中3条蛋白条带起反应,分子量分别是26000、14000和12000Mr。BSA-ELISA检测短穗鱼尾葵花粉特异性IgE,最适粗浸液稀释度为1：100,血清稀释倍数为1：5,生物素化抗体为1：1000,辣根过氧化物酶标记的链霉亲和素（strepavidin-HRP）为1：1000。在此条件下BSA-ELISA与浸液皮试比较,检出结果与皮试阳性患者血清符合率为90%,与皮试阴性患者符合率为80%,与健康人对照检测符合率为100%。结论本实验对短穗鱼尾葵花粉主要变应原进行了分离和鉴定,BSA-ELISA法测定结果与皮肤挑刺试验初步比较符合率较好。     

酮替酚对重组Bla g2变应原诱导小鼠过敏性哮喘疗效的观察

支气管哮喘的发病率和死亡率逐年上升。研究发现对蟑螂变应原过敏和哮喘的发病相关。酮替酚是治疗哮喘的一种常用药物。Bla g2是德国小蠊变应原的主要组成之一，研究发现60％～80％的德国小蠊变应原过敏病人血清能检测出Bla g2特异的IgE。为此，我们观察了酮替酚对rBla g2致敏的哮喘小鼠预防性治疗的效果，     

南京地区过敏性紫癜患儿血清过敏原特异性IgE结果分析

目的 回顾性分析南京医科大学附属儿童医院过敏性紫癜(Henoch-Schonlein purpura,HSP)患儿的过敏原检测情况,为临床诊治提供参考。方法 采用德国MEDIWISS过敏原体外检测系统,检测本院最近四年内接诊的1026例HSP患儿的血清过敏原特异性免疫球蛋白E(specific immunoglobulin E,sIgE)的含量。结果 432例HSP患儿血清sIgE检出为阳性,阳性率为42.11%(432/1026),该432例HSP患儿血清过敏原sIgE分布以1~2级为主,学龄组患儿血清过敏原sIgE阳性率占总人数的65.74%(284/432),远高于婴幼儿组(27例)和学龄前组(121例)(F值分别为7.71和4.05,P值均<0.05)。结论 患儿体内sIgE水平不同程度的增高对HSP的诊治具有一定意义。控制患儿与过敏原接触是防治HSP的关键。     

点免疫结合试验在特异性IgE检测中的应用

本文应用点免疫结合试验(DIBA)同时检测三种变应原(粉尘螨、屋尘、蒿属花粉)特异性IgE抗体。50例过敏性哮喘病人的DIBA结果与ELISA基本一致(符合率为90～92％),两者的半定量值之间存在显著的相关性;与皮试结果亦较相符(符合率为60.7～80％)。 该方法简便易行,无需贵重仪器;试验结果可目测定性或半定量,也可用光密度计扫描定量;吸附有多种抗原的薄膜可长时间保存,适用于临床作为变应性疾病变应原的过筛试验。     

Total serum IgE, allergy skin testing, and the radioallergosorbent test for the diagnosis of allergy in asthmatic children

Correlations of total serum IgE, skin test reactivity, and specific IgE antibodies to selected antigens were evaluated in asthmatic children. There was a significant difference in mean IgE level of each positive RAST score group compared with that of the RAST-negative score for dog epithelium, Candida, ragweed, and Bermuda grass allergen. The correlation coefficient between the total IgE and the RAST to D. farinae was 0.39 (P less than .05). There was no significant correlation between the total IgE and the RAST to D. pteronyssinus, Candida, dog epithelium, ragweed, Eucalyptus pollen, and Bermuda grass (P greater than .05). This indicates a low total serum IgE concentration does not exclude the possibility of significant elevation of specific IgE to a common allergen. Concordance for results of intradermal skin testing and RAST was high for most allergens. Lower efficiency for dog allergen and Candida suggests greater sensitivity of allergy skin testing for these allergens.     

Relationship of Allergen-Specific IgE Antibodies, Skin Prick Tests and Allergic Disorders in Unselected Adolescents

The relationship between serum levels of allergen-specific IgE (RAST) and skin prick test reactivity and allergic disorders was evaluated in 137 subjects randomly selected from an adolescent population. All subjects were prick tested with six common allergens, interviewed and physically examined. In addition, serum was collected for RAST analysis with three to six allergens. At least one positive RAST result (score 1-4) was observed in 40% and at least two positive RASTs in 22% of the subjects. Boys experienced more RAST reactions and generally with higher scores than girls. For instance, 26% of boys but only 11% of girls were RAST positive to timothy grass pollen. The correlation between prick test and RAST results was better with pollens than with house dust and animal epithelia. When the test results were discordant, the skin test was usually positive and RAST negative. Many of the small skin reaction (weal diameter 3-4 mm) were accompanied by a negative RAST. Respiratory allergy was closely connected with both positive skin test and RAST reactivity, while atopic dermatitis was less related. In 17% of the adolescents positive skin tests and in 14% positive RASTs occurred in the absence of any allergic symptoms. We conclude that a positive RAST score 3-4 to inhaled allergens is a strong indicator of clinical allergy but low scores 1-2 are frequently found in healthy young people.     

The relationship of respiratory allergy, skin test reactivity, and serum IgE in a community population sample.

The relationship between prick and intradermal skin test reactivity and serum levels of total and specific IgE was evaluated in 311 subjects selected from a general population. Test results were related to the historical allergy status of the subjects. Prick test reactivity to 14 common local allergens correlated with the presence of allergy symptoms. Similarly, mean total serum IgE (PRIST) levels were significantly higher (p < 0.02) in allergic (187.9 IU) than in nonallergic subjects (107 IU) and were found to be positively correlated with the degree of prick test reactivity. Conversely, intradermal reactions following a negative prick test for that allergen showed no correlation with either the clinical allergy status or the level of total serum IgE. Bermuda-specific IgE was found to correlate closely with prick reactivity to that allergen as an overall agreement of 89.2% was observed. In contrast, only 2 of 12 positive Bermuda intradermal tests ≥5 mm and none of 38 smaller reactions following a negative prick response were associated with positive RASTs. The results strongly suggest that prick test reactivity correlates with both total and specific IgE and allergic symptomatology, but intradermal reactions in the absence of prick reactivity do not correlate with either clinical or immunologic evidence of allergy.     

Humoral and Cell-Mediated Immune Responses to Dog Dander and Hair in Asthmatic Children

Dog dander and hair (DDH) specific IgA, IgG and IgE antibodies from serum samples Of 202 asthmatic children, and in nasal secretion from 4 to 15 years were measured by enzyme-linked immunosorbent assay. The results were compared with clinical history, and with allergy test (skin prick test, provocation test and RAST) using the same DDH extract. A blood sample for the in vitro lymphocyte stimulation test was obtained from 40 children, and a nasal secretion sample for analysis of the local DDH-specific IgA, IgG and IgE antibody levels was collected form 35 of them. In children of dog-keeping families, higher serum levels of DDH-specific antibodies, especially IgE antibodies, were observed if the dog had been in the home already during the first years of the child's life. The serum levels of DDH-specific antibodies, however, did not correlate with the degree of the present exposure to dogs. The serum levels of DDH-specific or total IgE, or with the results of skin prick or provocation test. The serum levels of DDH-specific IgA were highest in children who were subjectively most sensitive to dogs. Nasal levels of DDH-specific IgE correlated positively with serum specific IgE levels. The correlation was weaker between nasal and serum titers of specific IgG, and not significant between nasal and serum IgA antibody levels, Specific IgE antibody levels were higher, while specific IgA and IgG antibody levels were lower, in nasal secretion form subjects with nasal symptoms on contact with dogs, when compared with subjects with other complaints (asthma, conjunctival or skin reactions). DDH-specific IgG levels correlated negatively with specific IgE level in the nasal secretion from subjects with a positive provocation test result, while the correlation was positive in subjects with a negative provocation test. The in vitro lymphocyte response to DDH did not correlate with the results of allergy test, or with the levels of DDH-specific antibodies in serum or in nasal secretion.     

Evaluation of MAST-26, newly developed system for the detection of IgE antibodies]

MAST-26 is a new allergy testing system which allows simultaneous determination of allergen-specific IgE antibody levels for 26 allergens using 200 microliters of patient serum. To evaluate the effectiveness of MAST-26 for the detection of allergen-specific IgE antibody, a total of 100 serum samples were collected from allergic patients at five facilities, and allergen-specific IgE antibody was measured by MAST-26. 14% of them were positive to > or = 10 allergens. If the patients had severe allergic symptoms, they were likely to show positive to many allergens. A good correlation was found between the results obtained by MAST-26 with those measured by CAP RAST and by intradermal skin test. It was concluded that MAST-26 is an effective screening method for the detection of allergen-specific IgE.     

Allergic reactivity and socio-economic level in a tropical environment

As some factors associated with the tropical environment can modify the expression of atopic disease, various indicators of allergic reactivity were compared between allergic and non-allergic subjects of different socio-economic level in Caracas, Venezuela (Lat. 10°N). The socio-economic levels considered were high (HSEL), medium-high (MSEL) or low (LSEL). As generally found in temperature climates, in the HSEL the total serum IgE levels of allergic patients were significantly greater than those of nonallergic individuals (geometric means of 274 vs 126 IU/ml, respectively), as were also the specific serum IgE antibody levels (55.6 vs 23.8% positive, respectively, for house dust). These results correlated closely with the skin-test reactivity of these subjects (60.3 vs 17.5% positive for house dust). In this group, the degree of intestinal helminthic infection was low (5.6% positive for Ascaris). In contrast, for the MSEL where the degree of parasitic infection was higher (13.0%), the total serum IgE levels were elevated in both allergic and non-allergic subjects (602 vs 363 IU/ml). Similarly, positivity for specific IgE antibody was high, and comparable between allergies and non-allergies of this group (61.5 vs 54.2%), as was also the case for skin-test reactivity (71.9 vs 60.4%). In the LSEL, parasitic infection was prevalent (47.6%), and the total serum IgE levels were markedly elevated, with little difference occurring between allergic and non-allergic individuals (2269 vs 1981 IU/ml). The positivity for specific IgE antibody was high, and effectively independent of the allergic state (75.6 vs 53.7%), but in contrast the skin test reactivity was relatively low (22.0 vs 9.8%). The lack of correlation between skin test and specific IgE results in this group appeared to have     

The presence of IgE on the surface of lymphocytes in nasal polyps

The presence of IgE-bearing lymphocytes in nasal polyps was correlated with the patients' atopic status. Following surgical removal, the polyp tissue was treated with hyaluronidase and a single-cell suspension was obtained. Lymphocytes were isolated by gradient centrifugation, and the fluorescent antibody technique was used to study the presence of various immunoglobulin markers on the surface of lymphocytes. The presence of IgE-bearing cells was correlated with serum IgE levels, history of allergy, and skin test reactions. Patients with a positive atopic history had intermediate to high serum IgE levels. There was no correlation between IgE level and skin reactivity in these patients. Good correlation was obtained between the number of IgE-bearing cells in nasal polyps and serum IgE levels in atopic patients. The IgE-bearing cells represented 10 to 40 per cent of total immunoglobulin-bearing lymphocytes. No IgE-bearing cells were detected in five of six patients with a negative atopicf history and negative skin tests. Thus IgE may be synthesized within nasal polyps of atopic patients, and the polyps in atopic patients may have a different etiology from those in nonatopic patients.     

Influence of hyposensitization with Dermatophagoides pteronyssinus extract on clinical score, total and specific IgE levels, and skin test in asthmatic patients

To evaluate the effects of immunotherapy on clinical response, on IgE serum level, on radioallergosorbent test (RAST), and on skin tests, a prospective study was performed by a follow-up of 73 asthmatic patients allergic for house dust during hyposensitization with Dermatophagoides pteronyssinus extract. No relationship could be found between the evolution of clinical score, skin tests and RAST, but 91% of the patients with a decreasing IgE serum level had satisfactory clinical results. Serial determinations of serum IgE levels during hyposensitization showed two patterns of evolution with a favourable prognostic value: a continuously decreasing serum IgE or a primary increase followed by a late decrease.     

Comparison of VIDAS Stallertest and Pharmacia CAP assays for detection of specific IgE antibodies in allergic children

In vitro determination of specific IgE antibodies in serum is the most frequently used method, besides the skin test, for diagnosing allergies. Standardized and reproducible assays of specific IgE antibodies contribute to the quality of diagnosis and treatment of allergic disease. This study compared the results and performance characteristics of the Pharmacia CAP system and a new specific IgE method using the VIDAS Stallertest (manufactured by bioMériux). To evaluate their clinical efficiency, the results of the CAP and VIDAS Stallertest assays were compared with skin prick test (SPT) results. After allergic patients completed SPTs, serum samples were collected and CAP and VIDAS Stallertest assays were performed to determine specific IgEs for Dermatophagoides farinae, D. pteronyssinus, cockroach, and alternaria. For egg and milk, we measured only the correlation between the 2 in vitro assays. When SPT was used as a reference standard, the sensitivity and specificity of the CAP assay was a little higher in respect to all inhalant allergens. There were significant correlations between the results of VIDAS Stallertest and CAP assays for IgE antibodies to inhalant and food allergens. This study indicates that the VIDAS Stallertest and Pharmacia CAP assays are feasible and replicable for measuring allergen-specific IgE.     

Assessing skin prick tests reliability in ECRHS-I

Introduction:  Atopy, the clinical definition of an immunoglobulin E (IgE) high-responder, can be documented either by the detection of IgE antibodies in serum or by a positive skin prick test. Epidemiological studies use different reaction sizes to define a skin test reaction as positive or negative. The aim of the study was to identify the best cut-off level for skin prick tests.
Method:  Using the data collected during the European Community Respiratory Health Survey (ECHRS I) the association of serum allergen-specific IgE and skin prick tests [ Dermatophagoides pteronyssinus (Der p), cat, timothy grass and Cladosporium ] were assessed.
Results:  The proportion of the 11 355 subjects (49.9% men), with positive skin tests ranged from 10.4% (cut-off >5 mm) to 20.9% (cut-off >0 mm) for Der p, 3.5–10.2% for cat, 9.3–16.6% for timothy grass and 0.2 and 2.3% for Cladosporium . For identifying subjects with detectable specific IgE (>0.35 kU/l) the most appropriate cut-off appeared to be over 0 mm for Der p, cat and timothy grass (Youden Index over 0.81). However, the relationship between serum IgE and skin prick test for Cladosporium was weak (Youden index under 0.56).
Conclusion:  In epidemiological studies, a single method may be chosen to assess allergenic sensitivity. A cut-off level of over 0 mm for skin prick tests was best at identifying those with allergen-specific IgE.