原標(biāo)題：塵螨主要過(guò)敏原在過(guò)敏原免疫治療過(guò)程中對(duì)特異性IgG4應(yīng)答有重要作用
　　①背景：在過(guò)敏原特異性免疫治療(AIT)期間，過(guò)敏原特異性IgG4增加。在本研究中，我們研究了在AIT過(guò)程中針對(duì)塵螨個(gè)體主要過(guò)敏原的特異性IgG4。②方法：對(duì)塵螨敏感的變應(yīng)性鼻炎(52例)患者，采用標(biāo)準(zhǔn)化的螨蟲(chóng)提取物進(jìn)行皮下免疫治療。僅接受藥物治療的對(duì)塵螨敏感的過(guò)敏性鼻炎患者作為對(duì)照(n=14)。分別在AIT前、6個(gè)月和12個(gè)月后檢測(cè)各組對(duì)Dp、d.farina(Df)及相應(yīng)的主要過(guò)敏原(Dp1和Df1)和2組(Dp2和Df2)的特異性IgE和IgG4。
　?、劢Y(jié)果：免疫治療組的癥狀和藥物綜合評(píng)分明顯下降。在AIT過(guò)程中，對(duì)Dp1、Df1、Dp2和Df2過(guò)敏原的特異性IgG4表達(dá)顯著增加(Dp: 0.3、0.99、2.72;Dp1: 0.16、0.67、2.04;Dp2: 0.10、0.49、1.49;Df: 0.38, 1.04, 2.62;Df1: 0.12、0.37、1.01;Df2: 0.1 0.44 1.27 (AIT前、6個(gè)月、12個(gè)月 mgA/L)。在塵螨提取物IgG4與個(gè)體亞群過(guò)敏原IgG4的相關(guān)性中，兩種濃度(12個(gè)月后:Dp-Dp1: r=0.99;Dp-Dp2: r = 0.93;Df-Df1: r = 0.93;Df-Df2: r=0.95)和增長(zhǎng)水平(12個(gè)月后:Dp-Dp1: r=0.69;Dp-Dp2: r = 0.59;Df-Df1: r = 0.90;Df-Df2: r=0.77 (P<0.0001 for all)均存在明顯的相關(guān)性。在同一檢測(cè)儀器(UniCAP系統(tǒng))下，Df1和Df2 IgG4對(duì)Df特異性IgG4反應(yīng)的貢獻(xiàn)率為87%，而Dp1和Dp2在AIT治療12個(gè)月時(shí)對(duì)Dp IgG4反應(yīng)的貢獻(xiàn)率為130%。④結(jié)論：我們的研究結(jié)果強(qiáng)調(diào)了主要過(guò)敏原在AIT標(biāo)準(zhǔn)化和設(shè)計(jì)中的重要性
延伸閱讀
JACI                                                         
House Dust Mite Major Allergens Contributes Significantly to Specific IgG4 Response during Allergen Immunotherapy
DOI: https://doi.org/10.1016/j.jaci.2015.12.1244
Abstract:
Rationale
Allergen-specific IgG4 increases during allergen specific immunotherapy (AIT). In this study, specific IgG4 against the individual major allergens of dust mites during AIT was investigated.
Methods
Patients of allergic rhinitis (n=52) sensitized to dust mite were treated with subcutaneous immunotherapy using standardized D. pteronyssinus (Dp) extract. Patients with allergic rhinitis (n=14) sensitized to dust mites who received medications alone were controls. Specific IgE and IgG4 against Dp, D.farina(Df) and corresponding major allergens of group 1 (Dp1 and Df1) and group 2 (Dp2 and Df2) were measured before AIT, 6 months and 12 months later.
Results
Combined symptom and medication scores significantly decreased in immunotherapy group. Specific IgG4 against Dp1, Df1, Dp2 and Df2 allergens increased significantly during AIT (Dp: 0.3, 0.99, 2.72; Dp1: 0.16, 0.67, 2.04; Dp2: 0.10, 0.49, 1.49; Df: 0.38, 1.04, 2.62; Df1: 0.12, 0.37, 1.01; Df2: 0.1, 0.44, 1.27. before AIT, 6 months and 12months later respectively, mgA/L). Of the correlations between dust mite extract IgG4 and the individual subgroup allergen IgG4, it was shown that there were strong correlations in terms of both concentrations (after 12 months: Dp-Dp1: r=0.99; Dp-Dp2: r=0.93; Df-Df1: r=0.93; Df-Df2: r=0.95) and levels of increase (after 12 months: Dp-Dp1: r=0.69; Dp-Dp2: r=0.59; Df-Df1: r=0.90; Df-Df2: r=0.77) (P<0.0001 for all). With the same testing instrument (UniCAP system), Df1 and Df2 IgG4 contributed 87% to Df specific IgG4 response, whereas Dp1 and Dp2 contributed 130% to Dp IgG4 response at the 12 months of AIT.
Conclusions
Our findings underscores the importance of major allergens in AIT standardization and design.
All Authors:
Jianjun Chen Yiwen You Yue Zhou Yanjun Wang Weijia Kong
　　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(zhuān)業(yè)診斷、治療、預(yù)防的共享平臺(tái)。