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　　原标题：尘螨致敏患者过敏原组份诊断
　　①背景：分子过敏诊断的应用可以提高特异性过敏原免疫治疗的疗效②方法：在2018年的5个月内，以437例年龄在34.6±5.4 岁的患者（其中56.1% 男性，43.9% 女性）为对象，使用Raptor Analysis MADx (kUA/L)对屋尘螨敏感的患者进行allergochip ALEX主要过敏原组份评估。③结果：106例(24.3%)对屋尘螨敏感。89例(83.9%)血清总IgE升高(294±4.3)。屋尘螨主要成分阳性情况如下:Der p 2  88例(83.1%)；Der p 1  48例 (45.3%);Der p 23  48例(45.3%)；Der p 5  25 例(23.6%)；Der p 7  18例 (17.0%)；和Der p11  9 例(8.5%)；粉尘螨的主要成分:Der f 1  67 例(63.2%)， Der f 2  65 例(61.3%);原肌球蛋白Der p10  9例(8.5%)。以主要过敏原Der p2和Der f1为主，范围从0.12 kU/l到38.2 kU/l，但只有4例(3.8%)只对Der p 5敏感；3例(2.8%)只对Der p23敏感；1例(0.9%)只对Der p11敏感；而9例(8.5%)对主要过敏原 Der p 5, 7, 11均敏感的病人，他们对这三种组份的特异性IgE水平比对Der p 2 和/或Der p 1的特异性IgE水平更高（p<0.05）。④结论：对室内尘螨敏感的患者可能对Der p1、Der p2同时敏感，对Der p5、7、11和23的特异性IgE的存在，提示应优化AIT制剂，使之含有多种过敏原组分。
延伸阅读
JACI
Allergen Component Diagnosis of Patients with House Dust Mite Sensitization
DOI: https://doi.org/10.1016/j.jaci.2018.12.718
Rationale
The use of molecular allergy diagnostics may enhance specific allergen immunotherapy (AIT).
Methods
437 patients aged 34.6±5.4 years, 56.1% males 43.9% females, were assessed over five months in 2018. The allergochip ALEX allowing major allergen component assessment was performed on patients sensitized to house dust mites, using Raptor Analysis MADx, (kUA/L).
Results  
106 (24.3%) were dust mite sensitized. Total serum IgE was elevated (294±4.3) in 89 (83.9%) individuals. Major components of D. Pteronyssinus seen were: Der p 2 – in 88 (83.1%); Der p 1 -in 48 (45.3%); Der p 23 – in 48 (45.3%); Der p 5 – in 25 (23.6%); Der p 7 – in 18 (17.0%); and Der p 11 – in 9 (8.5%) ; major components of D. Farinae: Der f 1 – in 67 (63.2%), Der f 2 – in 65 (61.3%); and tropomyosin Der p 10 in 9 (8.5%) of patients. Major components of Der p 2 and Der f 1 dominated, ranging from 0.12 kU/l to 38.2 kU/l, but 4 (3.8%) were sensitized only to Der p 5; 3 (2.8%) to Der p 23; 1 (0.9%) to Der p 11; and 9 (8.5%) co-sensitized to major components Der p 5, 7, 11 at higher levels (p<0.05) of sIgE, than to Der p 2 and/or Der p 1.
Conclusions
Patients with sensitization to house dust mites may have combinations of sensitization to Der p 1 and Der p 2 and sIgE to Der p 5, 7, 11 and 23 suggesting optimization of AIT may require presence of multiple allergen components.
All Authors:
A. Kurchenko G. Fedoruk
· Bogomolets National Medical University, Kiev, Ukraine
1. S. YurievLawrence M. Dubuske
Corresponding Author
E-mail address:Claudiagray.paediatrics@gmail.com
Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
Correspondence
Claudia Gray, Department of Allergology, Red Cross War Memorial Children's Hospital, Klipfontein Road, Cape Town 7700, South Africa
Tel.: +27 21 4066889
Fax: +27 21 4066888
E‐mail: Claudiagray.paediatrics@gmail.com
　　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。