交叉反应性糖类决定簇IgE对血清特异性IgE检测的影响

目的分析血清变应原特异性IgE(specific IgE,sIgE)检测结果与调查对象实际情况不符合率,探讨交叉反应性糖类决定簇IgE(IgE to carbohydrate cross-reactive determinants,CCD-IgE)对血清sIgE检测的影响。方法通过问卷方式收集1 715例体检人群资料,用斑点免疫印迹法(dot-IBT)检测血清CCD-IgE及19种变应原sIgE。结合问卷与sIgE检测结果,分析sIgE检测阳性与问卷不符合情况及CCD-IgE对sIgE检测的影响。结果各类变应原sIgE检测均存在与问卷主诉不符合的情况,其中花生最高(47.06%);sIgE阳性级别较低时不符合率相对较高;CCD-IgE阳性时较阴性时变应原sIgE阳性率较高(P<0.05);疑似变态反应病组和健康人组不符合者中CCD-IgE阳性率比较,差异有统计学意义(P<0.05)。结论 CCD可能与血清变态反应原sIgE发生交叉反应,当存在sIgE检测与临床实际情况不符合时应考虑CCD的影响。

Influences of IgE to carbohydrate cross-reactive determinants on detection of serum specific IgE

Objective To analyse the reasons of allergen-specific IgE(sIgE) failing to conform the actual condition of the objects and investigate the influences of IgE to carbohydrate cross-reactive determinants(CCD-IgE) on the detection of serum sIgE.Methods The information of 1 715 cases was collected by questionnaires,and 19 kinds of serum sIgE and CCD-IgE were detected by dot-immunoblot test(IBT).Based on questionnaires and the results of sIgE detection,the inconformity of sIgE with the questionnaires and the influence of CCD-IgE on the detection results of sIgE were analyzed.Results The inconformity of sIgE with the questionnaires was present in 19 kinds of allergen detected in this study.The highest inconformity rate(47.06%) was found in peanut allergen.The rate of inconformity was relatively higher in the cases with low level of positive sIgE and the cases with positive CCD-IgE than that in the cases of negative sIgE(P<0.05).Comparing the positive rates of CCD-IgE between the doubtful allergic subjects and healthy controls who showed inconformity of sIgE with clinical manifestation in questionnaires,a difference with statistical significance was found(P<0.05).Conclusion CCD may be the reason of inconformity of sIgE detection with the questionnaires resulting by cross-reaction.If sIgE results showed inconformity with the actual clinical symptoms,CCD should be taken into account.