Lai Ching-Ling, Shyur Shyh-Dar, Wu Cheng-Yu, Chang Ching-Long, Chu Szu-Hung
Department of Pediatrics, Mackay Memorial Hospital, No. 92, Sec. 2, Chung-Shan North Road, Taipei 104, Taiwan.
Acta Paediatr Taiwan. 2002 Sep-Oct;43(5):265-70.
Asthma is one of the most commonly occurring manifestation of allergy in Taiwan. Sensitivity to house dust mites is closely related to childhood asthma. This study was designed to investigate sensitized rates and average concentrations of specific IgE antibodies to 5 major house dust mites (HDMs) among asthmatic children. A total of 93 asthmatic children aged from 3 to 15 years were enrolled to measure their specific IgE concentrations in response to 5 different species of mites: Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), Dermatophagoides microceras (Dm), Euroglyphus maynei (Em), and Blomia tropicalis (Bt). The severity of hypersensitivity was classified based on the concentration of specific IgE as mild (0.35-3.5 kuA/L), moderate (3.5-50 kuA/L), and severe (> 50 kuA/L). Sixty-three asthmatic children were found to have specific IgE to at least one mite. The percentage of these 63 children who had specific IgE to Dp, Df, Dm, Em and Bt were 87%, 85%, 84%, 77%, and 65%, respectively. Patients with specific IgE to Dp, Df, Dm, and Bt, had a high percentage of moderate and severe hypersensitivity (83.6%, 83.4%, 81.4%, 70.6%, respectively). However, patients sensitized to Em have relatively lower concentration of specific IgE Ab, with 75% of them in the mild range. Some patients had positive IgE antibody to Em (3.2%), and Bt (3.2%) even though they had none to Dp and Df. We conclude that Dm and Bt are also important mite allergens in atopic children. Conventional testing that assays only for sensitivity to Dp and Df would fail to demonstrate 6.4% of mite sensitized asthmatic children.
哮喘是台湾最常见的过敏表现之一。对屋尘螨过敏与儿童哮喘密切相关。本研究旨在调查哮喘儿童中对5种主要屋尘螨(HDM)的致敏率及特异性IgE抗体的平均浓度。共纳入93名3至15岁的哮喘儿童,检测他们对5种不同螨类:粉尘螨(Dp)、屋尘螨(Df)、微角尘螨(Dm)、梅氏嗜霉螨(Em)和热带无爪螨(Bt)的特异性IgE浓度。根据特异性IgE浓度将过敏严重程度分为轻度(0.35 - 3.5 kuA/L)、中度(3.5 - 50 kuA/L)和重度(> 50 kuA/L)。发现63名哮喘儿童对至少一种螨有特异性IgE。这63名儿童中对Dp、Df、Dm、Em和Bt有特异性IgE的比例分别为87%、85%、84%、77%和65%。对Dp、Df、Dm和Bt有特异性IgE的患者中,中重度过敏的比例较高(分别为83.6%、83.4%、81.4%、70.6%)。然而,对Em致敏的患者特异性IgE抗体浓度相对较低,其中75%处于轻度范围。一些患者即使对Dp和Df无特异性IgE抗体,但对Em(3.2%)和Bt(3.2%)有阳性IgE抗体。我们得出结论,Dm和Bt也是特应性儿童重要的螨过敏原。仅检测对Dp和Df敏感性的传统检测方法会漏诊6.4%的螨致敏哮喘儿童。