背景：過敏原組分檢測（CRD）可以幫助建立免疫球蛋白E（IgE）致敏譜和潛在風(fēng)險，并確定特異性IgE是主要致敏還是交叉反應(yīng)性的結(jié)果，特別是對于那些多重致敏的患者。
方法：我們招募了432名塵螨致敏的呼吸道過敏性疾病患者，采用CRD檢測研究了中國廣東省17種過敏原組分的致敏性和交叉反應(yīng)性，并描述過敏原組分之間的潛在關(guān)聯(lián)。
結(jié)果：在432例患者中， 17種組分血清特異性IgE中Der p 1（81.48%）、Der f 2（77.78%）、Der f 1（74.07%）、Der p 2（66.20%）和Der p 23（54.63%）是塵螨致敏呼吸道過敏患者的主要致敏組分，而蟑螂、蟹、蝦的陽性率較低。粗提物過敏原陽性的樣品中，Der f 2（91.06%）和Der f 1（86.72%）為Der f的主要致敏成分，Der p 1（94.52%）、Der p 2（78.36%）、Der p 23（63.29%）為Der p的主要致敏成分，而Der p 7（34.25%）、Der p 5（17.81%）、Der p 10（12.05%）、Der p 3（1.92%）均低于50.00%。Blo t 5（54.55%）是Blo t的主要組成部分之一。所有Bla g成分的陽性率分別為：rBla g 2（15.56%）>rBla g 5（8.89%）>rBla  g4（4.44%）>rBla g 1（1.11%）。唯一可用的Pen a 1組分的陽性率為9.43%。通過分層聚類和最優(yōu)尺度分析，將17個組分大致劃分為5個不同的致敏聚類。此外，從維恩圖的結(jié)果來看，每個類群中的過敏原組分都有很高的共敏性和交叉反應(yīng)的比例。無論年齡、總IgE水平和疾病類型因素如何，基于層次聚類分析，我們觀察到同一類別中的每個組分有相似的致敏譜。Cypress 發(fā)揮的作用有限，只有 1/22 SPT 單一致敏患者報告食物反應(yīng)（p < 0.073）。
結(jié)論：使用CRD可以進一步了解引起過敏癥狀的過敏原組分的流行病學(xué)數(shù)據(jù)。Der p1、Der p 2、Der p 23、Der f 1、Der f 2為研究隊列的主要致敏組分。Blo t 5在所有人群中的陽性率為28.01%，Blo t陽性樣本的CRD陽性率為54.45%。此外，CRD允許我們識別更多潛在的過敏原關(guān)聯(lián)，如共同的敏感性和組分蛋白之間的交叉反應(yīng)?；谶@些結(jié)果，我們建議，當(dāng)患者被確定為對特定的過敏原敏感時，臨床醫(yī)生可以更多地關(guān)注與之密切相關(guān)的其他過敏物質(zhì)。



延伸閱讀
Int Arch Allergy Immunol
Identifying Potential Co-Sensitization and Cross-Reactivity Patterns Based on Component-Resolved Diagnosis
DOI: 10.1159/000504320
Abstract:
Background: Component-Resolved diagnosis (CRD) can help to establish immunoglobulin E (IgE) sensitization profiles and potential risks and determines whether specific IgE is the result of primary sensitization or cross-reactivity, especially for those who are polysensitized.
Methods: We recruited 432 patients with mite-sensitized respiratory allergic diseases to study the co-sensitization and cross-reactivity of the 17 allergen components in Guangdong Province, China, using the CRD method and to describe the potential association between allergen components.
Results: Among the 432 patients, serum specific immunoglobulin E of the 17 components. Der p 1 (81.48%), Der f 2 (77.78%), Der f 1 (74.07%), Der p 2 (66.20%) and Der p 23 (54.63%) were the main sensitized components in patients with mite-sensitized respiratory allergy, while the   components of cockroach, crab, and shrimp had a lower positive rate. In the crude extract allergen-positive samples, Der f 2 (91.06%) and Der f 1 (86.72%) were the major sensitized components of Der f, while Der p 1 (94.52%), Der p 2 (78.36%), Der p 23 (63.29%) were the major sensitized components of Der p, and other components of Der p such as Der p 7 (34.25%), Der p 5 (17.81%), Der p 10 (12.05%), Der p 3 (1.92%) were all below 50.00%. Blo t 5 (54.55%) was one of the major components of Blo t. The positive rates of all Bla g components were as follows, rBla g 2 (15.56%) >rBla g 5 (8.89%) >rBla g 4 (4.44%) >rBla g 1 (1.11%). The positive rate of the only available pen a 1 component was 9.43%. Using hierarchical cluster and optimal scale analysis, 17 components can be roughly divided into 5 different sensitization clusters. Also, from the results of the Venn diagram, the allergen component in each cluster has a high proportion of co-sensitization and cross-reactivity. Regardless of age, total IgE levels, and disease type factors, similar sensitization profiles were observed for each component in the same category based on hierarchical clustering analysis.
Conclusion: Epidemiological data on allergen components causing allergic symptoms can be further understood using CRD. Der p 1, Der p 2, Der p 23, Der f 1, Der f 2 as the primary sensitizing component of the study cohort. The positive rate for Blo t 5 was 28.01% for all populations and 54.45% for Blo t-positive samples. In addition, CRD allows us to identify more potential allergen associations such as common sensitivities and cross-reactions between component proteins. Based on these results, we suggest that when patients are identified as sensitized to a particular allergen, clinicians can pay more attention to other allergy components that are closely related to it.
First Author:
Zhifeng Huang
Corresponding author
Baoqing Sun
Correspondence:
Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University 151 Yan Jiang Road, Guangzhou, Guangdong 510120 (China)