原標(biāo)題：芹菜過(guò)敏體外組份診斷的評(píng)價(jià)
　　①之前的研究已經(jīng)證實(shí)現(xiàn)有的商業(yè)化的芹菜提取物制劑在診斷芹菜過(guò)敏中靈敏度的不足。②我們對(duì)基于重組和純化天然芹菜過(guò)敏原的特異性IgE檢測(cè)與基于提取物的特異性IgE檢測(cè)進(jìn)行比較，評(píng)價(jià)前者的診斷性能，并研究交叉反應(yīng)性碳水化合物決定簇特異性IgE的干擾及其生物活性。③24名對(duì)芹菜的雙盲安慰劑對(duì)照食物挑戰(zhàn)結(jié)果呈陽(yáng)性的受試者，20例白樺花粉過(guò)敏而對(duì)芹菜耐受的特應(yīng)性對(duì)照，20例非特應(yīng)性受試者入選研究隊(duì)列。通過(guò)免疫ImmunoCAP，研究了芹菜過(guò)敏原(rApi g1.01、rApi g4、nApi g5)、提取試劑(芹菜、樺樹、艾蒿、梯牧草花粉)、樺樹花粉過(guò)敏原(rBet v1、rBet v1)和交叉反應(yīng)碳水化合物的IgE結(jié)合。根據(jù)嗜堿性介質(zhì)釋放度測(cè)定過(guò)敏原的生物活性。④ ImmunoCAP組分分析顯著提高了檢測(cè)芹菜特異性IgE的敏感性20%。38%的芹菜過(guò)敏患者對(duì)碳水化合物結(jié)構(gòu)敏感，其對(duì)糖蛋白Api g5的敏感與游離的多聚糖之間存在極好的相關(guān)性。特應(yīng)性對(duì)照的陽(yáng)性結(jié)果主要由蛋白質(zhì)過(guò)敏原引起，而碳水化合物表位的影響較小。過(guò)敏原誘導(dǎo)介質(zhì)釋放的能力以Bet v1 > Api g1 > Api g5的順序下降，證實(shí)IgE對(duì)碳水化合物表位的生物活性較低。⑤與基于提取物的診斷相比，組份診斷靈敏度從67%提高到88%。對(duì)Api g5的敏感性是由其多糖分子引起的，但不影響診斷特異性。
延伸閱讀
JACI:
Assessment of component-resolved in vitro diagnosis of celeriac allergy
https://doi.org/10.1016/j.jaci.2009.07.033
Abstract:
Background
Previous studies have demonstrated insufficient sensitivity of commercially available celeriac extract reagents in the diagnosis of celeriac allergy.
Objective
We sought to assess the diagnostic performance of specific IgE determination based on recombinant and purified natural celeriac allergens in comparison with an extract-based assay and to investigate interference by IgE to cross-reactive carbohydrate determinants and its biologic activity.
Methods
Twenty-four subjects with a positive double-blind, placebo-controlled food challenge result to celeriac; 20 atopic control subjects with birch pollen allergy who tolerated celeriac; and 20 nonatopic subjects were enrolled. IgE binding was investigated for celeriac allergens (rApi g 1.01, rApi g 4, and nApi g 5), extract reagents (celeriac, birch, mugwort, and timothy grass pollen), birch pollen allergens (rBet v 1 and rBet v 2), and cross-reactive carbohydrate determinants by means of ImmunoCAP analysis. Biologic activity of allergens was determined based on basophil mediator release.
Results
Component-resolved ImmunoCAP analysis considerably increased the sensitivity to detect celeriac-specific IgE by 20%. Sensitization to carbohydrate structures was detected in 38% of patients with celeriac allergy, and there was an excellent correlation between sensitization to the glycoprotein Api g 5 and isolated glycan. Positive results among atopic control subjects were mainly caused by protein allergens, whereas the effect of carbohydrate epitopes was marginal. The ability of allergens to induce mediator release decreased in the order Bet v 1 > Api g 1 > Api g 5, confirming the low biologic activity of IgE to carbohydrate epitopes.
Conclusion
Component-resolved diagnosis allowed an increase in diagnostic sensitivity from 67% to 88% compared with extract-based diagnosis. Sensitization to Api g 5 was attributable to its glycan moieties but did not interfere with diagnostic specificity.
All Author:
Kerstin BauermeisterMScaBarbara K.Ballmer-WeberMDbMerimaBublinPhDcPhilippFritscheMDbKay-Martin O.HanschmannMScaKarinHoffmann-SommergruberPhDcJonasLidholmPhDdChristinaOberhuberPhDeStefanieRandowaThomasHolzhauserPhDaStefanViethsPhDa
　　創(chuàng)建過(guò)敏性疾病的科研、科普知識(shí)交流平臺(tái)，為過(guò)敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺(tái)。