原標(biāo)題：塵螨主要過敏原在過敏原免疫治療過程中對特異性IgG4應(yīng)答有重要作用
　　①背景：在過敏原特異性免疫治療(AIT)期間，過敏原特異性IgG4增加。在本研究中，我們研究了在AIT過程中針對塵螨個體主要過敏原的特異性IgG4。②方法：對塵螨敏感的變應(yīng)性鼻炎(52例)患者，采用標(biāo)準(zhǔn)化的螨蟲提取物進行皮下免疫治療。僅接受藥物治療的對塵螨敏感的過敏性鼻炎患者作為對照(n=14)。分別在AIT前、6個月和12個月后檢測各組對Dp、d.farina(Df)及相應(yīng)的主要過敏原(Dp1和Df1)和2組(Dp2和Df2)的特異性IgE和IgG4。③結(jié)果：免疫治療組的癥狀和藥物綜合評分明顯下降。在AIT過程中，對Dp1、Df1、Dp2和Df2過敏原的特異性IgG4表達顯著增加(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個月、12個月 mgA/L)。在塵螨提取物IgG4與個體亞群過敏原IgG4的相關(guān)性中，兩種濃度(12個月后:Dp-Dp1: r=0.99;Dp-Dp2: r = 0.93;Df-Df1: r = 0.93;Df-Df2: r=0.95)和增長水平(12個月后: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。在同一檢測儀器(UniCAP系統(tǒng))下，Df1和Df2 IgG4對Df特異性IgG4反應(yīng)的貢獻率為87%，而Dp1和Dp2在AIT治療12個月時對Dp IgG4反應(yīng)的貢獻率為130%。④結(jié)論：我們的研究結(jié)果強調(diào)了主要過敏原在AIT標(biāo)準(zhǔn)化和設(shè)計中的重要性
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)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺。