IgE receptor-bearing lymphocytes in allergic and nonallergic children

Using a monoclonal anti-human IgE receptor (Fc epsilon R) antibody, the percentage of Fc epsilon R(+) cells among peripheral blood lymphocytes in children with or without allergic disorders was determined. The percentage of Fc epsilon R(+) cells in 63 nonallergic children was 4.3 +/- 1.5%, which did not vary with age and was equal to that of adults (4.2 +/- 1.2%). Allergic younger children (0-2 yr) showed a significantly higher percentage of Fc epsilon R(+) cells (7.7 +/- 3.0%) than nonallergic younger children (0-2 yr) (4.0 +/- 1.3%, p less than 0.001). Similarly, in allergic younger children, serum IgE levels (geometric mean = 58.9 IU/ml) were also significantly higher than those of nonallergic younger children (geometric mean = 2.0 IU/ml) (p less than 0.01). A positive correlation between the percentages of Fc epsilon R(+) cells and serum IgE levels was observed (Spearman rank = 0.88, p less than 0.01] in eight allergic younger children (0-2 yr) with serum IgE levels higher than 100 IU/ml. The increase in the percentage of Fc epsilon R(+) cells in allergic younger children (0-2 yr) was not a secondary phenomenon caused by serum IgE because serum IgE levels in these children were much lower than the concentration at which IgE enhance Fc epsilon R expression on lymphocytes. In conclusion, Fc epsilon R(+) lymphocytes may play a regulatory role in IgE synthesis in allergic younger children (0-2 yr).     

变态反应性疾病患儿血清特异性IgE检测的临床意义

目的　探讨血清特异性IgE(sIgE)与儿童变态反应病发病的关系 ,为临床防治提供依据。 方法　采用法玛西亚公司的免疫CAP诊断系统 ,以荧光酶联免疫法测定sIgE。 结果　 71例患儿中可查到 5 4例 4 8种变应原阳性的sIgE ,有些患儿对多种变应原呈阳性反应。支气管哮喘患儿阳性检出率为 74 % (37∶5 0 ) ;变应性鼻炎患儿阳性检出率为 6 4 % (7∶11) ;特应性皮炎及湿疹患儿阳性检出率为 80 % (8∶10 )。主要阳性变应原为户尘螨、屋尘、蒿草、烟曲霉等吸入性变应原和鸡蛋白、牛奶、花生、黄豆等食物性变应原。年幼儿组 (3～ 6岁 )以食物性变应原为主 ;年长儿组 (7～ 15岁 )以吸入性变应原为主。对上述 8种变应原的sIgE两组之间定量比较 ,经秩和检验发现吸入性变应原蒿草的sIgE在组间有明显差异 ,年长儿组高于年幼儿组 (P <0 0 5 ) ;食物性变应原牛奶的sIgE在组间有明显差异 ,年幼儿组高于年长儿组 (P <0 0 5 )。结论　上述 8种变应原是引起太原地区儿童变态反应病的主要变应原 ,随年龄增长血清中吸入性变应原的sIgE的阳性率增多 ,食物性变应原的sIgE的阳性率减少 ;sIgE对外源性变态反应病阳性检出率高。     

437例变态反应性疾病患儿血清特异性IgE抗体检测和分析

目的：了解长沙地区儿童变态反应性疾病的过敏原状况。方法：采用AllergyScreen过敏原定量检测系统检测437例变态反应性疾病患儿血清中总IgE和特异性IgE抗体水平。结果：总IgE阳性率为68.9%,特异性IgE阳性率为69.1%;常见过敏原为户尘螨粉尘螨、牛肉、羊肉、牛奶、猫狗毛皮屑。户尘螨粉尘螨阳性率在变应性鼻炎中最高,达86.0%,特应性皮炎次之,为41.2%,湿疹、荨麻疹相对较低,分别为27.6%,20.0%;猫狗毛皮屑在特应性皮炎、湿疹中相对较高,为23.5%和18.1%,在荨麻疹和变应性鼻炎中较低,为10.0%和8.7%;牛奶、牛肉、羊肉的阳性率在这4种过敏性疾病中均较高,但在4种过敏性疾病之间差别不明显。3岁以上吸入性过敏原阳性率明显高于3岁以下（P＜0.01）。结论：在长沙地区,过敏原对儿童变态反应性疾病有着重要影响,特别是户尘螨粉尘螨、猫狗毛皮屑、牛肉、羊肉、牛奶。［中国当代儿科杂志,2009,11（7）：543-545］     

吸入变应原sIgE在不同气道过敏性疾病儿童中的分布特征

目的了解不同气道过敏性疾病患儿吸入变应原血清特异性Ig E(slg E)的分布特征。方法应用Uni CAP250变应原定量Ig E检测系统的荧光酶联免疫法,对256例3~14岁气道过敏疾病患儿测定9种常见吸入变应原的血清slg E。256例患儿按临床诊断分为:变应性鼻炎组(简称"鼻炎组",37例)、支气管哮喘组(简称"哮喘组",82例)和变应性鼻炎合并支气管哮喘组(简称"鼻炎并哮喘组",137例)。比较3组患儿9种吸入变应原阳性检出率的分布差异,并比较3组患儿变应原致敏级别和致敏种类数的差异。结果哮喘组、鼻炎组和鼻炎并哮喘组患儿吸入变应原血清s Ig E的阳性检出率分别为57.3%(47/82)、86.5%(32/37)、82.5%(113/137),3组间比较差异有统计学意义(P0.05)。哮喘组、鼻炎组、鼻炎并哮喘组患儿常见变应原均依次为霉菌类(32.9%、54.1%、48.9%)、尘螨类(30.5%、45.9%、46.0%)、花粉类(26.8%、35.1%、32.8%)、宠物类(12.2%、27.0%、18.2%)、蟑螂(9.8%、5.4%、5.8%)。鼻炎组和鼻炎并哮喘组患儿霉菌混合的阳性检出率均高于哮喘组,差异有统计学意义(均P0.0166)。3组患儿9种变应原的致敏级别和致敏种类数比较差异无统计学意义。结论支气管哮喘、变应性鼻炎或二者合并患儿前3位吸入变应原均依次是霉菌类、尘螨类、花粉类;与支气管哮喘相比,霉菌致敏可能与变应性鼻炎关系更密切;这3种常见气道过敏性疾病吸入变应原的致敏分布具有相似性。     

Skin prick testing predicts peanut challenge outcome in previously allergic or sensitized children with low serum peanut-specific IgE antibody concentration

Peanut allergy is transient in some children but it is not clear whether quantitating peanut-specific IgE by Skin Prick Test (SPT) adds additional information to fluorescent-enzyme immunoassay (FEIA) in discriminating between allergic and tolerant children. To investigate whether SPT with a commercial extract or fresh foods adds additional predictive information for peanut challenge in children with a low FEIA (<10 k UA/L) who were previously sensitized, or allergic to peanuts. Children from a hospital-based allergy service who were previously sensitized or allergic to peanuts were invited to undergo a peanut challenge unless they had a serum peanut-specific IgE>10 k UA/L, a previous severe reaction, or a recent reaction to peanuts (within two years). SPT with a commercial extract, raw and roasted saline soaked peanuts was performed immediately prior to open challenge in hospital with increasing quantity of peanuts until total of 26.7 g of peanut was consumed. A positive challenge consisted of an objective IgE mediated reaction occurring during the observation period. 54 children (median age of 6.3 years) were admitted for a challenge. Nineteen challenges were positive, 27 negative, five were indeterminate and three did not proceed after SPT. Commercial and fresh food extracts provided similar diagnostic information. A wheal diameter of >or=7 mm of the commercial extract predicted an allergic outcome with specificity 97%, positive predictive value 93% and sensitivity 83%. There was a tendency for an increase in SPT wheal since initial diagnosis in children who remained allergic to peanuts while it decreased in those with a negative challenge. The outcome of a peanut challenge in peanut sensitized or previously allergic children with a low FEIA can be predicted by SPT. In this cohort, not challenging children with a SPT wheal of >or=7 mm would have avoided 15 of 18 positive challenges and denied a challenge to one out of 27 tolerant children.     

肥胖对轻中度过敏和非过敏性哮喘儿童肺功能的影响

目的比较肥胖对轻中度过敏及非过敏性哮喘患儿基础肺功能、气道高反应性(AHR)的影响。方法选择230例初诊、非急性发作轻中度哮喘患儿,根据皮肤点刺试验(SPT)分为过敏组和非过敏组,再根据不同体质指数(BMI)Z评分分为过敏体质量正常组、过敏超重组、过敏肥胖组、非过敏体质量正常组、非过敏超重组、非过敏肥胖组;检测各组患儿的肺功能及支气管激发试验并进行比较。结果各组轻中度哮喘患儿的呼气流速峰(PEF)、用力呼气75%流量(MEF75)、MEF50、MEF25、最大呼气中段流量(MMEF)的差异有统计学意义(P0.05),均以非过敏肥胖组最低,非过敏超重组次低。过敏哮喘患儿各指标与BMI-Z评分不相关(P0.05),非过敏哮喘患儿肺功能指标PEF、MEF75、MEF50、MEF25、MMEF与BMI-Z值呈负相关(r=-0. 314～-0. 273,P均0. 01)。各组间不同等级AHR发生率的差异无统计学意义(P 0. 05)。支气管激发试验后,各组患儿间PEF、MEF75、MEF25、MMEF下降率的差异有统计学意义(P0.05),均以非过敏肥胖组的下降率为最低。结论肥胖对非过敏哮喘儿童肺功能影响更大,且主要影响通气功能。     

FcεR I-β基因启动子区多态性与哮喘儿童血清总IgE的关系

目的　探讨IgE高亲和力受体 β链 (FcεRI β)基因启动子区 10 9C/T多态性与儿童哮喘血清总IgE水平的关系。方法　采用聚合酶链式反应 限制性片断长度多态性 (PCR RFLP)法检测了 2 0 0 1年 12月至 2 0 0 3年 2月吉林大学第一临床医院 12 6例哮喘儿童和 87名正常儿童的FcεRI β 10 9C/T基因多态性 ;用酶联免疫法检测血清总IgE水平和空气过敏原。结果　FcεRI β 10 9C/T基因型分布及等位基因频率哮喘组与正常对照组比较 ,差异均无显著性意义 ;哮喘组、对照组过敏原检测阳性率在突变基因型与未突变基因型间比较 ,差异均无显著性意义 ;哮喘组FcεRI β 10 9C/T突变纯合型个体的Log10 IgE水平高于突变杂合型及未突变型个体的水平 (P <0 0 5 )。结论　FcεRI β基因启动子区 10 9C/T不是汉族儿童哮喘的易感基因 ,与过敏原亦无关 ,但突变纯合子TT型与血清总IgE水平升高相关联。     

Effects of inhaled steroid treatment on serum eosinophilic cationic protein (ECP) and low affinity receptor for IgE (Fc epsilon RII/sCD23) in childhood bronchial asthma

OBJECTIVE: To assess the bone mineral content in well nourished patients with cystic fibrosis and to seek a correlation with fat-free mass. METHODS: Fourteen cystic fibrosis patients aged 6 to 20 years were studied and compared to 14 healthy controls matched for gender, age, and nutritional status. Bone mineral content was determined by dual energy x ray absorptiometry (DEXA). RESULTS: Nutritional inquiry showed higher ingestion of macronutrients and micronutrients by cystic fibrosis patients than by controls. Mean whole skeleton bone mineral content was 1.184 (SD 0.536) kg in cystic fibrosis patients and 1.229 (0.576) kg in controls (p = 0.84). Mean lumbar spine bone mineral content was 0.031 (0.013) kg and 0.031 (0.016) kg, respectively (p = 0.99). Anthropometry, bioelectrical impedance analysis, and DEXA showed that fat-free mass was similar in the two groups. Bone mineral content was strongly correlated to fat-free mass. Mean blood calcium, phosphorus, serum 25-hydroxyvitamin D (25-OHD), parathyroid hormone (PTH), and osteocalcin were similar in both groups. CONCLUSIONS: Bone mineral content and body composition are normal in a well nourished young cystic fibrosis population. Osteopenia previously reported in cystic fibrosis patients probably has nutritional origins and is therefore not related to a primary defect in bone mineral metabolism.     

Medical treatment reverses cytokine pattern in allergic and nonallergic chronic rhinosinusitis in asthmatic children

A Th2 cytokine pattern has recently been reported both in allergic and nonallergic chronic rhinosinusitis in asthmatic children. The aim of the study was to evaluate the cytokine pattern in chronic rhinosinusitis in allergic and nonallergic asthmatic children before and after medical treatment. Thirty asthmatic children were evaluated, 18 males and 12 females (mean age 9.1 years). Sixteen were allergic and 14 were nonallergic. All children were asthmatic and suffered from chronic rhinosinusitis, whose diagnosis was confirmed by endoscopy. All of them were treated with amoxicilline-clavulanate (20 mg/kg b.i.d.) and fluticasone propionate aqueous nasal spray (100 µg daily) for 14 days; a short course of oral corticosteroid was also prescribed (deflazacort 1 mg/kg daily for 2 days, 0.5 mg/kg daily for 4 days and 0.25 mg/kg daily for 4 days). Rhinosinusal lavage and nasal cytology were performed in all subjects before and after medical treatment. IL4 and IFNγ were measured by immunoassay and inflammatory cells were counted by conventional staining. Thirteen allergic children and 12 nonallergic children showed a negative endoscopy after the treatment. Allergic subjects showed a significant decrease of IL4 (p = 0.0002) and a significant increase of IFNγ (p = 0.03) after the treatment. Nonallergic children showed a significant decrease of IL4 (p = 0.0007) and a nonsignificant increase of IFNγ. A significant reduction of the inflammatory infiltrate was detected in all asthmatic children (p < 0.05). This study confirms a Th2 polarization in chronic rhinosinusitis both in allergic and nonallergic asthmatic children. Moreover, the medical treatment of chronic rhinosinusitis reversed the cytokine pattern from a Th2 towards a Th1 profile both in allergic and nonallergic children.     

Exhaled nitric oxide, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis

Exhaled nitric oxide (eNO) levels are correlated with several markers of atopy and inflammatory activity in the airways, but the relationship between eNO and total serum IgE has not been fully elucidated in the context of allergic sensitization. The aim of this study was to investigate the relationship between eNO, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis. eNO levels, lung function, skin prick tests and total serum IgE were determined in 109 children (mean age, 10.4 yr) with mild intermittent asthma and in 41 children (mean age, 10.1 yr) with allergic rhinitis; 25 healthy non-atopic children were recruited as controls. eNO levels (median) were significantly higher in patients with asthma (22.7 p.p.b.) and in those with allergic rhinitis (15.3 p.p.b.) than in healthy controls (5.9 p.p.b.). Children with allergic asthma had higher eNO levels than children with allergic rhinitis. A significant positive correlation was found between eNO and total serum IgE (asthma, r = 0.42, p < 0.0001; allergic rhinitis, r = 0.31, p < 0.01), and between eNO and the number of positive skin prick tests (asthma, r = 0.31, p < 0.0001; allergic rhinitis, r = 0.39, p < 0.01). eNO levels were better correlated with total IgE than with the number of positive skin prick tests. This correlation was independent of allergic sensitization. High total serum IgE represents a specific and predictive marker of eNO increase in children with asthma or allergic rhinitis. This finding adds further support to the hypothesis that increased serum IgE could be a marker itself of airway inflammation in patients with allergic disease.     

Cytokines in breast milk from allergic and nonallergic mothers

The allergy-preventing effect of breast-feeding remains controversial, possibly because of individual variations in the composition of the breast milk. The aim of this study was to investigate the concentrations of cytokines involved in allergic reactions and IgA antibody production in breast milk from allergic and nonallergic mothers. The cytokine concentrations were determined in colostrum and 1-mo. milk samples from 24 mothers with, and 25 mothers without, atopic symptoms, using commercial ELISA kits. The immunosuppressive cytokine transforming growth factor-beta was predominant and was detectable in all milk samples. IL-6 was detected in the majority of colostral and mature milk samples, whereas the other cytokines were less commonly detected. The concentrations of IL-6, IL-10, and transforming growth factor-beta, which are all involved in IgA synthesis, correlated with each other and with total IgA concentrations in colostrum. The concentrations of IL-4 were higher in colostrum from allergic than nonallergic mothers, and similar trends were seen for IL-5 and IL-13. In conclusion, transforming growth factor-beta and IL-6 were the predominant cytokines in human milk. The correlation between the concentrations of cytokines involved in IgA synthesis, i.e. IL-10, IL-6, and transforming growth factor-beta, may explain the stimulatory effect on IgA production in breast-fed babies. Varying concentrations of IL-4, IL-5, and IL-13 may explain some of the controversy regarding the possible allergy-preventive effect of breast-feeding.     

Total serum IgE levels in children with pertussis

Total serum IgE levels were evaluated in 20 children with pertussis. Increased levels of serum IgE were observed in the group of children between the ages of 3 and 12 years, while normal levels of serum IgE were detected in the groups of children between birth and 24 months old and between 13 and 24 months old. A further and significant increment of serum IgE levels was also found after 10 days of hospitalization.     

Chemoattractant factors in breast milk from allergic and nonallergic mothers

The allergy-preventing effect of breast-feeding remains controversial, possibly because of individual variations in the composition of the breast milk. Recently, we showed that allergic mothers had higher concentrations of IL-4 and lower concentrations of ovalbumin-specific IgA in their breast milk than nonallergic mothers. The aim of this study was to investigate the concentrations of chemokines and cytokines that are chemotactic to cells involved in allergic reactions in breast milk from allergic and nonallergic mothers. Cytokine and chemokine concentrations were determined with ELISA in colostrum and mature milk samples from 23 mothers with and 25 mothers without atopic symptoms. IL-8 was detected in all milk samples. RANTES (regulated on activation, normal T cell expressed and secreted), eotaxin, and IL-16 were detected in 50%, 76%, and 48%, respectively, in colostrum and less commonly in mature milk. Macrophage inflammatory protein-1alpha, however, could not be detected in any of the samples. The concentrations of IL-8 and RANTES were higher in breast milk from allergic, compared with nonallergic, mothers. In conclusion, the presence of chemoattractant factors in breast milk may be responsible for the traffic of leukocytes from the maternal circulation to the breast milk. The higher concentrations of RANTES and IL-8 in allergic mothers may partly explain the controversy regarding the protective effect of breast-feeding against the development of allergy by stronger chemotaxis and activation of cells involved in allergic diseases, and possibly by elevated IgE production.     

Serum levels of the soluble low affinity receptor for IgE and soluble interleukin-2 receptor in childhood, and their relation to age, gender, atopy and allergic disease

Identifying immune factors associated with the development of atopy can enhance our understanding of the in vivo mechanisms involved and may have utility in paradigms designed to prevent disease. Two candidates sug-gested for such roles are the soluble low affinity receptor for IgE (sCD23) and the soluble interleukin-2 receptor (sCD25). To assess serum levels of these factors blood samples were collected at birth and at age 6 in a large nonselected population from Tucson, AZ. Log mean sCD23 and sCD25 lev-els decreased from birth to age 6, (for sCD23 0. 60 ffi 0. 26pg/l, n=340 and 0. 53 + 0. 28pg/l, n=333 and for sCD25 1. 95 i 0. 14pM. n=304 and 1. 86 ffi 0. 20pM, n=327. for the two ages respectively. Anglo children had lower sCD23 levels at birth compared to Hispanic children (p < 0.01); no effect of gender was observed. Skin test reactivity at age 6 was directly related to sCD25 levels at age 6 (p=0.007) and even levels at birth showed a similar trend (p=0.06). These relations were distinct from any relation to total se-rum IgE. No relation was observed with sCD23 levels for either skin test re-activity or serum IgE. The prevalences of asthma, rhinitis and eczema by age 6 were unrelated to sCD25 or sCD23 levels. The results indicate that soluble CD23 and CD25 have higher levels at birth than later in childhood and that the development of skin test reactivity may be associated with reg-ulatory mechanisms involving sCD25, whereas sCD23 was not similarly implicated.     

过敏性哮喘患儿T淋巴细胞CD40L表达和血清IgE相关性分析

过敏性哮喘是青少年常见疾病 ,ＩｇＥ引起的高气道反应是本病的主要特征。国外研究表明 :ＩｇＥ产生需要两个信号 ,第一是细胞因子白细胞介素 4(ＩＬ 4)和白细胞介素 13(ＩＬ 13 ) ,第二是Ｂ淋巴细胞表面ＣＤ4 0 和其在Ｔ淋巴细胞表面的配体ＣＤ4 0 Ｌ结合产生的信号传递[1] ,为此 ,我们检测了过敏性哮喘患儿急性发作时Ｔ淋巴细胞表面ＣＤ4 0 Ｌ与Ｂ淋巴细胞表面ＣＤ4 0 表达以及血清ＩＬ 4、ＩｇＥ水平变化 ,并作相关性分析 ,以了解ＣＤ4 0 Ｌ ＣＤ4 0 在哮喘发作机制中的作用。材料和方法1.检测对象 :患儿系上海中医药大学基础部哮喘专家…     

天津地区儿童血清变应原特异性IgE分布情况

目的:探讨天津地区2015年6月至2019年4月儿童血清变应原特异性IgE(sIgE)的分布情况及其特点。方法:对5 823例天津地区l～14岁儿童UniCAP系统(荧光酶联免疫法)血清变应原sIgE检测结果进行分析,探讨血清变应原sIgE的分布及其与性别、病种、年龄、季节的相关性。结果:1.在5 823例儿童中血清变...     

Domestic fungal viable propagules and sensitization in children with IgE mediated allergic diseases

In order to study the possible relationship between domestic fungal exposure and sensitization to fungi, the homes of 20 children with allergic diseases (mainly bronchial asthma) were inspected for visible fungal growth and airborne viable fungal propagules were sampled. Inclusion criterion was sensitization to at least one of the tested fungi as shown by proof of specific IgE in serum. Twelve of 19 homes (63%) revealed a considerable amounl of viable fungal propagules and/or visible fungal growth. Penicilli-um, Cladosporium, Aspergillus, Mycelia sterilia and yeasts were most prevalent. There was no clear-cut relationship to serologically proven sensitization.     

过敏性紫癜患儿血清细胞因子的检测及意义

目的 研究肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6和IL-8在过敏性紫癜和紫癜性肾炎发病中的作用.方法 采用双抗体夹心ELISA法检测过敏性紫癜患儿血清TNF-α、IL-6和IL-8的水平.结果 过敏性紫癜急性发病期血清TNF-α、IL-6和IL-8水平较对照组明显增高(P<0.01);在恢复期,TNF-α、IL-6和IL-8则明显下降;紫癜性肾炎时TNF-α、IL-6、IL-8水平较过敏性紫癜时有所增高(P<0.05).结论 TNF-α、IL-6和IL-8在过敏性紫癜和紫癜性肾炎的发病中发挥了一定的作用.