特应性疾病的特异性体外过敏诊断问题

Anna A. Barilo, S. Smirnova, V. D. Belenyuk, A. Savchenko, A. Borisov
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引用次数: 0

摘要

在世界范围内,特应性过敏性疾病的患病率稳步上升,例如,特应性支气管哮喘(ABA)和特应性皮炎(AD)。在变态反应性疾病的诊断、治疗和预防中,鉴别变态反应性疾病患者的致应原是至关重要的。韩国已经开发出了检测特定IgE的过敏原- q多重检测方法。Allergy-Q是基于一种免疫印迹方法,使用硝化纤维素膜作为固相固定过敏原,可以同时检测107种过敏原的过敏原特异性IgE。我们的目的是利用Allergy-Q测试系统,采用免疫印迹法对特应性皮炎、特应性支气管哮喘和牛皮癣患者血清中可检测到的食物、真菌、花粉、家庭、表皮过敏原特异性IgE抗体进行比较分析。本研究纳入特应性皮炎(AD, 1组,n = 9)、特应性支气管哮喘(ABA, 2组,n = 14)、牛皮癣(PS, 3组,n = 17)患者。采用韩国Allergy-Q测试系统,采用免疫印迹法测定血清中对32种最常见的食物、真菌、花粉、家庭、表皮过敏原的总免疫球蛋白E和E类过敏原特异性免疫球蛋白的浓度。我们发现,所有AD患者(n = 9)、85.7% (n = 12)的特应性支气管哮喘患者和47.1% (n = 8)的牛皮癣患者均存在特应性致敏。多价致敏在所有被检查人群中普遍存在。在研究食物过敏原的致敏谱时,发现AAA组患者对牛奶蛋白的阳性反应频率明显高于AD组和PS组。在所有研究组中,发现对Alternaria真菌的致敏在ABA患者组中频率最高。豚草花粉致敏在所有患者中都很常见。在AD和AAA组中,所有研究的过敏原都对家庭和表皮过敏原敏感,其中猫上皮和狗皮屑的阳性率最高。在目前的研究中,过敏症- q系统显示出与特定过敏症检查的初步数据一致。这种关系表明,过敏症- q免疫印迹法作为诊断特应性的其他体外测试的高效替代方法的潜力。Allergy-Q多重血清过敏原特异性IgE检测试剂盒的优点是处理时间短,血液样本量少,对致敏原的临床信息更广泛。
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Issues of specific in vitro allergological diagnosis of atopic conditions
There is a steady increase in the prevalence of allergic diseases of atopic origin worldwide, e.g., atopic bronchial asthma (ABA) and atopic dermatitis (AD). Identification of a causally significant allergen in allergic patients is crucial for the diagnosis, therapy and prevention of allergic diseases. Korea has developed the Allergy-Q multiplex test to detect specific IgE. Allergy-Q is based on an immunoblotting method using a nitrocellulose membrane as a solid phase for allergen immobilization and can detect allergen-specific IgE simultaneously to 107 allergens. Our aim was to conduct a comparative analysis for detectable allergen-specific IgE antibodies to food, fungal, pollen, household, epidermal allergens in blood serum by immunoblotting method using the Allergy-Q test system in patients with atopic dermatitis, atopic bronchial asthma and psoriasis. The study included patients with atopic dermatitis (AD, group 1, n = 9), atopic bronchial asthma (ABA, group 2, n = 14) and psoriasis (PS, group 3, n = 17). The concentration of total immunoglobulin E and allergen-specific immunoglobulins of class E in blood serum to 32 most common food, fungal, pollen, household, epidermal allergens was determined by the immunoblotting method using the Allergy-Q test system (Korea). We have found that sensitization of atopic origin was observed in all patients with AD (n = 9), in 85.7% (n = 12) of patients with atopic bronchial asthma, and in 47.1% (n = 8) of patients with psoriasis. Polyvalent sensitization was shown to prevail in all groups of the examined persons. When studying the spectrum of sensitization to food allergens, a significantly increased frequency of positive reactions to cows milk protein was found in the group of patients with AAA as compared with AD and PS groups. Among all studied groups, sensitization to the Alternaria fungi was found at the highest frequency in the group of patients with ABA. Sensitization to ragweed pollen was very common in all groups of patients. Sensitization to household and epidermal allergens in the groups with AD and AAA was noted for all studied allergens with the highest positivity rates for the feline epithelium and dog dander. In the present study, the Allergy-Q system showed an agreement with preliminary data from a specific allergological examinations. This relationship suggests a potential for usage of the Allergy-Q immunoblotting method as a highly effective alternative to other in vitro tests for diagnosing atopy. An advantage of the Allergy-Q Multiplex Serum Allergen-Specific IgE Detection Kit is a short processing time, small amount of blood sample, and broader clinical information on the causative allergens.
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