原標(biāo)題：用改進(jìn)的診斷工具分析不同地區(qū)螨蟲過敏病人
　　①背景：不同種類的螨蟲可能是引起過敏的潛在原因，對它們之間的致敏性的比較研究很少。②目的：提高對不同地域塵螨過敏患者的診斷水平，在這些地區(qū)的環(huán)境中屋塵螨/粉螨與貯藏螨可能同時存在。③方法：研究隊列包含來自不同地區(qū)的477名患者(包括兒童和成人)，覆蓋了西班牙主要的螨蟲流行地區(qū)。全螨提取物的SPT、螨變應(yīng)原暴露水平、對8種過敏原的sIgE和特異性IgG4測定。在一組患者中進(jìn)行BAT和CAST。結(jié)果Dp和L. destructor在大西洋地區(qū)較為常見，而D. farinae在地中海地區(qū)居多。大約90%的患者對第一組和/或第二組過敏原過敏。第2組最常見且BAT中IgE反應(yīng)/致敏強(qiáng)度較高。sIgE與Der p2 /Der f2幾乎完全交叉反應(yīng)，但與lepd2沒有交叉反應(yīng)。第一組過敏原也具有交叉反應(yīng)性，但在一些患者中觀察到種類特異性反應(yīng)。lepd2特異性IgE的表達(dá)與對倉儲螨的SPT結(jié)果有相關(guān)性。兒童對Der p1的敏感性較高，而成人對lepd2的敏感性較高。對Der p2的IgE/IgG4比值較高與過敏性哮喘的發(fā)生有關(guān)。④結(jié)果：建立了一種改進(jìn)的診斷方法，第二組變應(yīng)原似乎在螨蟲過敏中起著主導(dǎo)作用，但由于第一組變應(yīng)原致敏在某些病人中可能具有特異性，而且在兒童中發(fā)病率較高，因此在設(shè)計螨蟲過敏疫苗時必須考慮到對主要的螨類和主要的變應(yīng)原的充分平衡。
　　延伸閱讀
JACI：
Analysis of mite allergic patients in a diverse territory by improved diagnostic tools DOI: doi: 10.1111/j.1365-2222.2012.03993.x
Abstract:
Summary
Background
There are few studies comparing the sensitization with mite allergens from different mite species which could potentially be the cause of allergy.
Objective
To improve the diagnosis of mite allergic patients from a diverse territory in which D. pteronyssinus/D. farinae mites together with storage mites could be present in the environment.
Methods
Four hundred and seventy-seven patients (both children and adults) from different regions, covering the main mite prevalent areas of Spain, were recruited. sIgE to eight allergens was measured together with SPT to whole mite extracts, level of mite allergen exposure, and specific IgG4. BAT and CAST was performed in a subgroup of patients. Results D. pteronyssinus and L. destructor were more prevalent in Atlantic areas, whereas D. farinae predominate in Mediterranean areas. About 90% of patients were sensitized to group 1 and/or group 2 allergens. Group 2 was the most prevalent, and the IgE response/ intensity of sensitization in BAT was higher. sIgE to Der p 2/Der f 2 was almost fully cross-reactive, but no cross-reactivity was detected with Lep d 2. Group 1 allergens were also cross-reactive, but in some patients a species-specific response was observed. sIgE to Lep d 2 was associated with SPT results to storage mites. Sensitization to Der p 1 was more frequent in children, whereas Lep d 2 sensitization was more frequent in adults. A higher ratio IgE/IgG4 to Der p 2 was associated with the presence of allergic asthma.
Conclusion
An improved diagnosis algorithm has been established. Group 2 allergens seem to have a leading role in mite allergy, but as group 1 sensitization could be speciesspecific in some patients and its prevalence is higher in children, an adequate balance on major mite species and major allergens must be consider in the design of mite allergy vaccines.
All Author:
D. Barber1 , J. Arias2 , M. Boquete3 , V. Cardona4 , T. Carrillo5 , G. Gala6 , P. Gamboa7 , J. C. Garc?′a-Robaina8 , D. Herna′ndez9 , M. L. Sanz10, A. I. Tabar11, C. Vidal12, H. Ipsen1 , F. de la Torre1 and M. Lombardero
　　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。