背景：屋塵螨（HDM）是一種重要的吸入性過(guò)敏原，與特應(yīng)性疾病高度相關(guān)。常規(guī)過(guò)敏原組分檢測(cè)一般僅包含32種登記命名的戶塵螨組分中的4種。許多組分與臨床相關(guān)性和病理學(xué)尚不清楚。
目的：旨在探究幾種HDM組分與過(guò)敏性鼻炎、過(guò)敏性哮喘和特應(yīng)性皮炎的相關(guān)性，以確定具有生物標(biāo)記物潛力的過(guò)敏原，并將其轉(zhuǎn)移到診斷中。
方法：重組表達(dá)并純化了9種戶塵螨組分中的8種（nDer p 1、rDer p 2、rDer p 5、rDer p 7、rDer p 10、rDer p 13、rDer p 20、rDer p 21、rDer p 23）。用多重陣列分析了384名表現(xiàn)出不同臨床表型的HDM過(guò)敏個(gè)體的致敏模式。
結(jié)果：對(duì)三種以上的塵螨組分（致敏計(jì)數(shù)）的致敏與過(guò)敏性哮喘和/或特應(yīng)性皮炎相關(guān)。與過(guò)敏性鼻炎相比，過(guò)敏性哮喘患者對(duì)Der p 5和Der p 21的反應(yīng)更頻繁。特應(yīng)性皮炎患者更常對(duì)Der p 5、Der p 20和Der p 21等過(guò)敏。在75%的患者中，Der p 20 IgE>80 kU/L與嚴(yán)重特應(yīng)性皮炎相關(guān)。
結(jié)論：本研究證明了致敏計(jì)數(shù)和某些過(guò)敏原（Der p 5、Der p 20和Der p 21）的臨床重要性，這些過(guò)敏原尚未用于常規(guī)診斷。檢測(cè)這些項(xiàng)目以及考慮診斷中的致敏計(jì)數(shù)將提高HDM過(guò)敏患者的診斷和風(fēng)險(xiǎn)評(píng)估。



延伸閱讀
Allergy
Specific IgE against the house dust mite allergens Der p 5, 20 and 21 influences the phenotype and severity of atopic diseases
DOI: 10.1111/all.15553
Abstract:
Background: House dust mites (HDM) are among the most important sources for airborne allergens with high relevance for atopic diseases. Routine tests contain only 4 of 32 registered allergens of Dermatophagoides pteronyssinus. Clinical relevance and pathomechanistic properties of many allergens are not well understood.
Objective: The association of several HDM allergens with allergic rhinitis, allergic asthma, and atopic dermatitis was investigated to identify allergens with biomarker potential and to transfer them into diagnostics.
Methods: Eight out of nine D. pteronyssinus allergens (nDer p 1, rDer p 2, rDer p 5, rDer p 7, rDer p 10, rDer p 13, rDer p 20, rDer p 21, rDer p 23) were recombinantly expressed and purified. Sensitization patterns of 384 HDM-allergic individuals exhibiting different clinical phenotypes were analyzed with a serum-saving multiplex array.
Results: Sensitization to more than three mite allergens (sensitization count) was associated with allergic asthma and/or atopic dermatitis. Reactions to Der p 5 and Der p 21 were more frequent in allergic asthma compared to allergic rhinitis. Atopic dermatitis patients were more often sensitized to Der p 5, Der p 20, and Der p 21 among others. Der p 20-IgE> 80 kU/L was associated with severe atopic dermatitis in 75% of patients.
Conclusion: This study demonstrates the clinical importance of the sensitization count and of certain allergens (Der p 5, Der p 20, and Der p 21) not available for routine diagnostics yet. Implementing them as well as the sensitization count in diagnostic measures will improve diagnosis and risk assessment of HDM-allergic patients.
First Author:
Theresa Walsemann
Corresponding author
Uta Jappe
Correspondence:
Uta Jappe, Division of Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Parkallee 35,23845 Borstel, Germany.