Resano A, Sanz M L, Oehling A
Department of Allergology and Clinical Immunology, University Clinic, Faculty of Medicine, University of Navarra, Spain.
J Investig Allergol Clin Immunol. 1998 Nov-Dec;8(6):353-8.
In order to determine the prevalence of airborne mould sensitization and the reliability of the in vitro diagnostic techniques in daily practice (antigen-specific IgE and histamine release test), we performed a 3-year study in 2,200 patients diagnosed with rhinosinusitis and/or bronchial asthma. We found mould sensitization in 101 patients, 20% of whom presented monosensitization against airborne moulds, and the rest associated other sensitizations as follows: 53.7% against Dermatophagoides pteronyssinus, 45% against grass pollen and 30% against Olea europea. The most frequently involved moulds in our patients were Alternaria and Cladosporium. Seventy-six percent of the patients presented sensitization against Alternaria, 56% of whom were monosensitized, 26% presented cosensitization to Cladosporium and the remainder were sensitive to more than two moulds. Regarding Cladosporium, the percentage of patients was similar (66%), although only 23% were monosensitized and 46% presented an associated sensitization against Alternaria. We also observed a correlation between skin tests and both in vitro diagnostic techniques, with a relative sensitivity of the specific IgE determination compared to the skin test of 98% against Alternaria and 90.4% against Cladosporium, whereas the relative sensitivity of the histamine release test was 97.4% for Alternaria and 85% for Cladosporium. In conclusion, we think that in order to confirm the etiopathogenesis of the airborne moulds and before an immunotherapy treatment is indicated, the positive skin reactions should be confirmed by means of reliable laboratory diagnostic techniques, such as antigen-specific IgE determination and histamine release test.
为了确定气传霉菌致敏的患病率以及体外诊断技术在日常实践中的可靠性（抗原特异性IgE和组胺释放试验），我们对2200例诊断为鼻窦炎和/或支气管哮喘的患者进行了为期3年的研究。我们在101例患者中发现了霉菌致敏，其中20%的患者对气传霉菌呈现单一致敏，其余患者伴有其他致敏，具体如下：对粉尘螨致敏的占53.7%，对草花粉致敏的占45%，对油橄榄致敏的占30%。在我们的患者中，最常涉及的霉菌是链格孢属和枝孢属。76%的患者对链格孢属致敏，其中56%为单一致敏，26%同时对枝孢属致敏，其余患者对两种以上霉菌敏感。关于枝孢属，患者的比例相似（66%），尽管只有23%为单一致敏，46%同时对链格孢属致敏。我们还观察到皮肤试验与两种体外诊断技术之间存在相关性，与皮肤试验相比，特异性IgE测定对链格孢属的相对敏感性为98%，对枝孢属为90.4%，而组胺释放试验对链格孢属的相对敏感性为97.4%，对枝孢属为85%。总之，我们认为，为了证实气传霉菌的发病机制并在指示进行免疫治疗之前，应通过可靠的实验室诊断技术，如抗原特异性IgE测定和组胺释放试验，来确认阳性皮肤反应。
