原標(biāo)題：廣州市多螨過(guò)敏性哮喘患者過(guò)敏原特異性IgE分子成分的初步研究
目的：采用多重微陣列組分診斷（CRD）方法，研究中國(guó)南方過(guò)敏性哮喘患者的過(guò)敏原致敏情況。
方法:對(duì)南方某三級(jí)轉(zhuǎn)診中心57例多螨致敏的過(guò)敏性哮喘患者血清標(biāo)本進(jìn)行多重CRD特異性IgE檢測(cè)，檢測(cè)112種單一過(guò)敏原及其組分的特異性IgE。將結(jié)果與單次ImmunoCAP的結(jié)果進(jìn)行比較。
結(jié)果：在ISAC中，nDer f 1（71.9%）、rDer f 2（73.7%）、nDer p 1（70.2%）和rDer p 2（66.7%）的致敏率最高，而rDer p 10和其他貯藏螨組分的陽(yáng)性率僅為10%。rFel d 1和rCan f 1分別在29.8%和14.0%的樣本中呈陽(yáng)性。其他動(dòng)物皮屑的陽(yáng)性率均低于7.0%。對(duì)花粉組分的致敏主要為nCyn d 1（17.5%）和nPhl p 4（12.3%），4例nPhl p 4、nCyn a 2陽(yáng)性、 nCyn d 1（CCD）陽(yáng)性，均合并哮喘和鼻炎。對(duì)霉菌（rAsp f 3）、蟑螂（nBla g 7）和單線蟲（rAni s 3）的敏感性相同，為8.8%。93.0%的患者對(duì)一種以上的組分敏感，其中有一半以上（57.9%）對(duì)五種或五種以上的組分呈陽(yáng)性。合并哮喘和鼻炎患者（AA + AR）比僅哮喘患者（AA）對(duì)更多的組分敏感。AA + AR患者的nPhl p 4陽(yáng)性率顯著高于僅AA患者（χ2 = 4.31，P = 0.038）。
與ImmunoCAP相比，ISAC對(duì)屋塵螨和粉塵螨的檢出率相當(dāng)高，但熱帶無(wú)爪螨致敏患者匯中rBlo t 5的檢出率僅為10.0%。過(guò)敏原組分相關(guān)性優(yōu)化標(biāo)度分析表明，rDer p10與食物過(guò)敏相關(guān)。
結(jié)論：本項(xiàng)目是第一個(gè)基于中國(guó)南方的多重芯片CRD研究，ISAC結(jié)果顯示屋塵螨組分是導(dǎo)致哮喘患者過(guò)敏的主要過(guò)敏原組分。AA+AR合并患者相較于僅AA患者對(duì)更多組分敏感。其他陽(yáng)性率較高的組分包括花粉組分nCyn d 1、nPhl P 4和動(dòng)物皮屑組分rFel d 1和rCan f 1。ISAC中的rBlo t 5可能并不代表中國(guó)南方患者的熱帶無(wú)爪螨的主要致敏組分。



原始出處
molecular immunology
A pilot study on the allergen-specific IgE to molecular components on polysensitized mite allergic asthmatic patients in Guangzhou, China
DOI: 10.1016/j.molimm.2018.11.004
Abstract:
Objective: Using multiplex microarray-based component resolved diagnosis (CRD) to investigate the allergen sensitization profile of allergic asthma patients in southern China.
Method: Serum samples from 57 polysensitized mite allergic asthmatic patients in a tertiary referral centre of southern China were tested with multiplex CRD (ISAC) for specific immunoglobulin E (sIgE) against 112 single allergen and components. Result was then compared with those from singleplex ImmunoCAP.
Results: With ISAC, the highest sensitization was seen for nDer f 1 (71.9%), rDer f 2 (73.7%), nDer p 1 (70.2%) and rDer p 2 (66.7%), whereas rDer p 10 and other storage mites’ components only showed 10% positivity. rFel d 1 and rCan f 1 were found positive in 29.8% and 14.0% samples respectively. Other epithelia components had less than 7.0% positive rate. Sensitization to pollen components was dominated by nCyn d 1 (17.5%) and nPhl p 4 (12.3%), Carbohydrate cross-reactive determinants (CCD) was positive in 4 patients who were also positive to nPhl p 4, nCyn d 1 and rPla a 2, and all of them have combined asthma and rhinitis. The sensitivity to mold (rAsp f 3), cockroach (nBla g 7) and Anisakis simplex component (rAni s 3) were all the same at 8.8%. 93.0% patients were sensitive to more than one component, with more than half of them (57.9%) positive to five or more components. Patients with combined asthma and rhinitis (AA+AR) were sensitive to more components than those with asthma only (AA). Positive rate to nPhl p 4 was significantly higher in patients with AA+AR than with AA only (χ2=4.31, P= 0.038).Compared with ImmunoCAP, ISAC showed a similar high detection rate for D. pteronyssinus and D. farinae, butonly 10.0% of B. tropicalis sensitive patients were positive to rBlo t 5. Optimal scale analysis on correlation of allergens components showed rDer p 10 was associated to food allergy.
Conclusion: Being the first multiplex microarray based CRD study on southern Chinese, ISAC showed house dust mites components were the major allergen components led to sensitization in asthmatic patients. Patients with combined AA+AR were sensitive to more components than those with AA only. Other components with higher positive rate include pollen components nCyn d 1, nPhl P 4 and animal dander components rFel d 1 and rCan f 1. For B. tropicalis, the rBlo t 5 in ISAC may not represent the major Blomia component in southern Chinese patients.
First Author:
Haisheng Hu
Correspondence:
State Key Laboratory of Respiratory Disease, First, Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, 510120, Guangdong, China.
2023-02-10  Article