青霉素过敏病人嗜碱性粒细胞表面CD63的变化

目的评价嗜碱性粒细胞表面CD63在诊断青霉素过敏反应中的价值。方法采用流式细胞过敏原刺激试验(FAST)的方法检测43例青霉素过敏病人血中嗜碱性粒细胞在9种抗原刺激后(PG、PV、AMP、AX、6-APA、PHA、PHOA、PHPG、NPG)表面CD63的变化。采用放射免疫吸附试验(RAST)和酶联免疫吸附试验(ELISA)检测8种特异性IgE和IgG抗体。结果43例青霉素过敏病人中有28例为CD63阳性,15例健康对照受试者中有1例阳性。其敏感性为65.12%,特异性为93.33%。CD63和特异性IgE在皮试阳性组的敏感性高于特异性IgG(P<0.05),并且在IgE阳性组中,CD63的阳性率高于特异性IgG(P<0.05)。结论CD63可作为检测青霉素类过敏反应嗜碱性粒细胞特异性激活标志物。

Changes in the expressions of CD63 on basophils in patients with penicillin allergy

Aim To evaluate the value of expressions of CD63 on basophils in diagnosing allergy to penicillins.Methods The expressions of CD63 on basophils activated with 9 kinds of antigens(PG:penicillin G,PV:phenoxomethylpenicillin,AMP:ampicillin,AX:amoxicilloyl,6-APA:6-aminopenicillanic acid,PHA:phenylacetic acid,PHOA:phenoxacetic acid,PHPG:N-(ρ-hydroxyphenyl)glycine,NPG:N-phenylglycine) were detected by FAST(Flow cytometric allergen stimulation test) in 43 patients with penicillins allergy.Eight types of specific IgE and IgG antibodies to penicillins were determinated by RAST and ELISA,respectively.Results The sensitivity and specificity of CD63 used as a marker in patients with penicillins allergy were 65.12% and 93.33%,respectively.Moreover,the sensitivities of CD63 and specific IgE were higher than those of specific IgG in patients with positive skin test(P<0.05),and the sensitivity of CD63 was also greater than that of specific IgG in patients with positive IgE(P<0.05).Conclusion The detection of CD63 expression by FAST was a particularly useful technique in the diagnosis of patients with penicillins allergy.