嗜碱性粒细胞上的CD63表达作为诊断花粉相关食物过敏的工具：敏感性和特异性
CD63 expression on basophils as a tool for the diagnosis of pollen-associated food allergy: sensitivity and specificity.
作者信息
Erdmann S M, Heussen N, Moll-Slodowy S, Merk H F, Sachs B
机构信息
Department of Dermatology and Allergology and Institute of Biometry, University hospital of RWTH Aachen, Aachen, Germany.
出版信息
Clin Exp Allergy. 2003 May;33(5):607-14. doi: 10.1046/j.1365-2222.2003.01660.x.
BACKGROUND
Basophil activation is associated with the expression of CD63. Because allergens can induce basophil activation by cross-linking specific IgE, increased CD63 expression has been proposed as a novel in vitro test for immediate type allergy.
OBJECTIVE
We compared the CD63-based basophil activation test (BAT) in the diagnosis of allergy to carrot, celery and hazelnut with skin prick tests (SPT) and measurement of allergen-specific IgE.
METHODS
Twenty-nine patients with a history of an oral allergy syndrome induced by carrot, celery or hazelnut (n = 20 for each allergen) and 20 controls were studied. SPT were performed with standardized and native carrot, celery and hazelnut extracts. Allergen-specific IgE was determined by the CAP FEIA method and basophil activation was determined by flow cytometry upon double staining with anti-IgE/anti-CD63 mAb.
RESULTS
SPT with native carrot, celery and hazelnut showed sensitivities of 100%, 100% and 90%, and specificities of 80%, 80% and 90%. SPT with commercial extracts of the same allergens gave sensitivities of 85%, 80% and 85%, and specificities of 80%, 80% and 90%. Sensitivity of allergen-specific IgE and the BAT for carrot, celery and hazelnut was 80% vs. 85%, 70% vs. 85%, and 80% vs. 90%, with corresponding specificities of 80% vs. 85%, 80% vs. 80%, and 95% vs. 90%. The cut-off for a positive BAT was 10% CD63+ basophils. Moreover, there was a positive correlation between IgE reactivity and the number of CD63+ basophils for all food allergens (carrot: r = 0.69, celery: r = 0.67, hazelnut: r = 0.66).
CONCLUSIONS
Quantification of basophil activation by CD63 expression is a valuable new in vitro method for diagnosis of immediate type food sensitization. Although double-blind placebo-controlled food challenges remain the gold standard, the CD63-based BAT may supplement routine diagnostic tests such as SPT or allergen-specific IgE in the future.
背景
嗜碱性粒细胞活化与CD63的表达相关。由于变应原可通过交联特异性IgE诱导嗜碱性粒细胞活化，因此有人提出将CD63表达增加作为速发型过敏的一种新型体外检测方法。
目的
我们比较了基于CD63的嗜碱性粒细胞活化试验（BAT）与皮肤点刺试验（SPT）及变应原特异性IgE检测在诊断对胡萝卜、芹菜和榛子过敏中的作用。
方法
研究了29例有胡萝卜、芹菜或榛子所致口腔过敏综合征病史的患者（每种变应原20例）和20例对照。用标准化及天然胡萝卜、芹菜和榛子提取物进行SPT。采用CAP FEIA法测定变应原特异性IgE，用抗IgE/抗CD63单克隆抗体双重染色后通过流式细胞术测定嗜碱性粒细胞活化情况。
结果
用天然胡萝卜、芹菜和榛子进行SPT时，敏感性分别为100%、100%和90%，特异性分别为80%、80%和90%。用相同变应原的商业提取物进行SPT时，敏感性分别为85%、80%和85%，特异性分别为80%、80%和90%。胡萝卜、芹菜和榛子的变应原特异性IgE及BAT的敏感性分别为80%对85%、70%对85%和80%对90%，相应的特异性分别为80%对85%、80%对80%和95%对90%。BAT阳性的临界值为10%的CD63+嗜碱性粒细胞。此外，所有食物变应原的IgE反应性与CD63+嗜碱性粒细胞数量之间均呈正相关（胡萝卜：r = 0.69，芹菜：r = 0.67，榛子：r = 0.66）。
结论
通过CD63表达定量嗜碱性粒细胞活化是诊断速发型食物致敏的一种有价值的新型体外方法。虽然双盲安慰剂对照食物激发试验仍是金标准，但基于CD63的BAT未来可能会补充SPT或变应原特异性IgE等常规诊断试验。
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