皮下免疫治疗的有效性达到了假莫西坦的全身提取物。阿根廷一名年轻妇女报告一例

R. Rodriguez, Irañeta Sg, M. Olgiati, L. L. Soprano, K. Mouchián, A. Alonso, V. Duschak
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摘要

本文首次报道1例棘假麦螨/蚕豆蚁蜇伤致过敏反应患者,制备全体提取物,研究其生化和免疫学特性,验证该非商业提取物皮下免疫治疗的疗效。1例阿根廷女患者,19岁,儿童期有变应性鼻炎和支气管哮喘背景,因不明昆虫叮咬和既往免疫治疗反复发作过敏反应。昆虫学分析表明,攻击昆虫为假蝇属和棘蚁属或蚕豆属蚂蚁。ELISA检测血清总IgE水平高(202 UI/ml),体内皮内试验显示6 mm轮焰反应阳性(提取液稀释1/100000)。用SDS-PAGE对提取物蛋白部分进行分析。银染色蛋白条带范围为20 ~ 220 kDa。在通过电印迹脱敏治疗之前,患者血清免疫识别的过敏原提取蛋白约为160、90和42/46 kDa的双条带。有趣的是,特异性皮下免疫治疗后,上述双波段几乎消失。治疗6年后,血清总IgE值明显下降,特异性皮内试验呈阴性,直至提取液稀释1/10。对该治疗的耐受性良好。综上所述,我们的研究结果表明,使用假莫西全身致敏提取物进行免疫治疗是非常有效的,免疫治疗后消失的IgE特异性双蛋白致敏提取物条带(42/46 kDa)是过敏性休克的原因。
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Efficacy of subcutaneous immunotherapy achieved with a whole-body extract of Pseudomyrmex ant. A case reported in a young woman, in Argentina
The aim of this work is to report for the first time a patient case with anaphylaxis by Pseudomyrmex acanthobius /favidulus ant sting, prepare an extract with the wholeant-body, to study their biochemical and immunological properties and to validate the efficacy of the subcutaneous immunotherapy with this non-commercial extract. An argentine woman patient, 19 years old, with background of allergic rhinitis and bronchial asthma in the childhood, suffered repeated episodes of anaphylaxis by non-identified insect’s stings and previous immunotherapies treatment. The entomologic analysis revealed that the aggressor insect was an ant belonging to Pseudomyrmex genera and acanthobius or favidulus species. High serum total levels of IgE (202 UI/ml) were measured by ELISA and a positive 6-mm wheal and flare reaction (extract dilution 1/100000) was revealed by in vivo intradermal test. A sample of the extract proteins fraction was analysed by SDS-PAGE. The silver stained protein bands ranged since 20 to 220 kDa. The patient serum immune-recognized allergenic extract proteins at approximately 160, 90, and a double band at 42/46 kDa prior to desensitization treatment by electro-blotting. Interestingly, post-specific-subcutaneous-immunotherapy the mentioned double band almost disappeared. After a 6-years-treatment, the total IgE serum values strongly decreased and the specific intradermal test was negative up to 1/10 extract dilution. The tolerance to the treatment was good. Altogether, our findings revealed that the immunotherapy performed with the whole-body-Pseudomyrmex ant allergenic extract was highly effective and the IgE specific-double protein allergenic extract bands (42/46 kDa) that disappeared after immunotherapy were responsible for the anaphylactic shock.
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