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　　原标题：食物过敏和过敏反应-2044 热带地区虾过敏中，基于组份的过敏原敏感性概况
　　评价一组虾过敏患者对尘螨、虾过敏原和原肌球蛋白的致敏性，用ImmunoCAP和 ImmunoCAP ISAC生物芯片定量检测105例样本的血清过敏原特异性IgE，根据确切的临床病史和对斑节对虾和凡纳滨对虾的食物激发试验结果将受试者进行分类。1A组：对两种虾的食物激发试验阳性（22例）或因严重的虾过敏反应送急诊但未进行食物激发试验（14例）（总计36例）；1B组：报道为虾过敏但食物激发试验为阴性（31例）；2组：贝类耐受尘螨敏感对照样本（38例）  105例样本除1例外均对三种尘螨(屋尘螨, 粉尘螨, 热带无爪螨)中的至少一种敏感，致敏率最高的是Blo t 5，接着是Der f 1，尘螨和虾的原肌球蛋白有高度的相关性(p<0.001)，与1B组相比，1A组的原肌球蛋白致敏率更高(Der p 10 [33.3%vs9.7%]，Pen m 1 [33.3%vs9.7%] p<0.037)，与2组相比，(Blo t 10 [19.4%vs0%], Pen m 1 [33.3%vs5.3%], Pen I 1 [27.8%vs5.3%], Lit v 1 [22.2%vs5.3%], p<0.05).与1B组(6.5%)和2组(5.2%)相比，1A组(22.2%)对Lit v 2的致敏率更高(p<0.093). Lit v 3, 4的致敏率低（<10%）。 虾组（ImmunoCAP f24）检测阳性+所有原肌球蛋白+所有虾过敏原来区分食物激发试验的阴阳性敏感性最高（81.8%），但是特异性低只有24.1%。Der p 10或任何虾原肌球蛋白阳性来判断虾过敏的特异性最高（93.1%），但敏感性低（31.8%）原肌球蛋白在物种之间存在高度交叉反应，并与热带虾过敏有显著的相关性，ISAC Immunocap提高了检测食物激发阳性和虾过敏的准确性。
　　延伸阅读


World Allergy Organization journal
Food allergy and anaphylaxis – 2044. Component resolved allergen sensitzation profiles in shrimp allergy in the tropics
DOI:org/10.1186/1939-4551-6-S1-P129
Abstract:
Background:Shellfish allergy is one of the commonest food allergies in the tropics.
Methods:Serum allergen-specific IgE of 105 subjects were quantified using ImmunoCAP and ImmunoCAP ISAC biochips. The subjects were classified based on a convincing clinical history and food challenge testing (FC) (dose=70g) to Penaeus monodon and Litopenaeus vannamei. Group1A: Either SA with FC positive to either shrimp (n =22) or SA admitted to emergency departments for severe reactions but no FC performed (n=14) (total n=36); and Group1B: Reported SA with FC negative (n=31). Group2: Shellfish tolerant DM sensitized controls (n= 38).
Results:All 105 subjects but one were sensitized to at least one of 3 DM tested (Dermatophagoides pteronyssinus, Dermatophagoides farina, Blomia tropicalis), with highest sensitization rates to Blo t 5 followed by Der f 1. DM and shrimp tropomyosin showed high correlation (p<0.001). Group1A had higher rates of sensitization to tropomyosins compared to Group1B (Der p 10 [33.3%vs9.7%], and Pen m 1 [33.3%vs9.7%], p<0.037); and to Group2 (Blo t 10 [19.4%vs0%], Pen m 1 [33.3%vs5.3%], Pen I 1 [27.8%vs5.3%], Lit v 1 [22.2%vs5.3%], p<0.05). Sensitization to Lit v 2 were higher in Group1A (22.2%) compared to Group1B (6.5%) and Group2 (5.2%) (p<0.093). The sensitization rates to Lit v 3, 4 were low (<10%). A positive test for a combination of shrimp (ImmunoCAP f24)+any tropomyosin+any shrimp allergens gave the highest sensitivity(81.8%) to distinguish FC positive from negative subjects but had a low specificity of 24.1%. The specificity was highest (93.1%) when using a positive test for Der p 10 or any shrimp tropomyosin, but sensitivity was low (31.8%).
Conclusions:Tropomyosins are highly cross reactive across species and is significantly associated with SA in the tropics. ISAC Immunocap improved the accuracy to detect FC+ve SA.
All Authors:
Irenaeus Paul Chia
Correspondence:
National University of Singapore, Singapore
All Authors:
Irenaeus Paul Chia, Gaik Chin Yap, Bee Wah Lee, Hugo Van Bever, Lynette Shek Pei-Shi, Irvin Francis A Gerez, Genevieve Llanora, Yew Kuang Cheng, Bernard Thong, MA Curotto De Lafaille, Chwee Ying Tang
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。