Mari A
Allergy Unit, National Health Service, Rome, Italy.
Clin Exp Allergy. 2003 Jan;33(1):43-51. doi: 10.1046/j.1365-2222.2003.01569.x.
The diagnostic approach to grass pollen allergy is now possible by detecting specific IgE to its allergenic components.
To compare the IgE reactivity to a timothy grass pollen extract with the IgE reactivity to eight allergenic components from the same source (Phl p 1, 2, 4, 5, 6, 7, 11, 12). Both were compared with the skin test reactivity to a timothy grass extract.
A population survey was carried out by means of the skin test to identify grass-allergic subjects, and to characterize them in terms of demographic and allergological parameters. Seven hundred and forty-nine sera were available for IgE detection to a timothy extract, to the recombinant Phl p 1, 2, 5, 6, 7, 11, 12, and to native Phl p 4 and bromelain. Results were stratified by means of demographic and allergy parameters.
Ninety-five per cent of the sera had detectable IgE to the timothy extract. Prevalence of IgE reactivity increased from 86.8% to 93.3% as the number of combined reactive molecules rose from 2 to 8. Adjusted prevalences for each allergen were: rPhl p 1 = 83%, rPhl p 2 = 55%, nPhl p 4 = 70%, rPhl p 5 = 50%, rPhl p 6 = 44%, rPhl p 7 = 7%, rPhl p11 = 43%, rPhl p 12 = 15%. Isolated reactivity to rPhl p 1 was 6%, whereas it was negligible for the remaining molecules. IgE reactivity prevalence and mean values differed when patients were stratified on the basis of their associated pollen reactivity and their skin test reactivity grade. No differences were found when age, symptom type and duration were considered. Up to eight-fold higher IgE concentrations were found when the sum of IgE to molecules was compared with IgE to the extract. Testing for the IgE reactivity to the glycan of the native Phl p 4 allergen showed a possible interference with prevalence and value estimation. Higher prevalence values were found in previously immunotherapy-treated patients.
The use of a complete panel of grass allergenic molecules can mimic the current use of allergenic extracts, but new relevant information, such as individual pattern of reactivity, adjusted prevalence, correct specific IgE concentration, can be achieved only by means of discrete allergenic molecules.
通过检测对草花粉变应原成分的特异性IgE，现在可以对草花粉过敏进行诊断。
比较对梯牧草花粉提取物的IgE反应性与对来自同一来源的八种变应原成分（Phl p 1、2、4、5、6、7、11、12）的IgE反应性。将两者与对梯牧草提取物的皮肤试验反应性进行比较。
通过皮肤试验进行人群调查，以识别对草过敏的受试者，并根据人口统计学和变应性参数对他们进行特征描述。749份血清可用于检测对梯牧草提取物、重组Phl p 1、2、5、6、7、11、12以及天然Phl p 4和菠萝蛋白酶的IgE。结果根据人口统计学和过敏参数进行分层。
95%的血清对梯牧草提取物有可检测到的IgE。随着反应性分子组合数量从2个增加到8个，IgE反应性的患病率从86.8%增加到93.3%。每种变应原的校正患病率为：rPhl p 1 = 83%，rPhl p 2 = 55%，nPhl p 4 = 70%，rPhl p 5 = 50%，rPhl p 6 = 44%，rPhl p 7 = 7%，rPhl p11 = 43%，rPhl p 12 = 15%。对rPhl p 1的孤立反应性为6%，而对其余分子的反应性可忽略不计。当根据患者相关的花粉反应性和皮肤试验反应性等级进行分层时，IgE反应性患病率和平均值有所不同。在考虑年龄、症状类型和持续时间时未发现差异。当将对分子的IgE总和与对提取物的IgE进行比较时，发现IgE浓度高出多达八倍。对天然Phl p 4变应原聚糖的IgE反应性检测显示可能会干扰患病率和值的估计。在先前接受免疫治疗的患者中发现了更高的患病率值。
使用完整的草变应原分子组合可以模拟目前使用变应原提取物的情况，但只有通过离散的变应原分子才能获得新的相关信息，如个体反应模式、校正患病率、正确的特异性IgE浓度。
