Michils A, Yernault J C, Noel E, Gossart B, Servais G, Duchateau J
Department of Chest Medicine, Erasme Hospital, Brussels, Belgium.
Cancer. 1992 May 1;69(9):2252-7. doi: 10.1002/1097-0142(19920501)69:9<2252::aid-cncr2820690907>3.0.co;2-q.
Previous studies have suggested an inverse relationship between atopy and cancer of mucosal surfaces. Atopy is classically assessed by detecting specific immunoglobulin E (IgE) antibodies against inhalant allergens. However, Platts-Mills recently proposed that atopy is the ability of an organism to recognize and to respond to limited doses of allergens presented at the mucosal level by producing not only IgE, but also immunoglobulin A and immunoglobulin G (IgG) antibodies. The authors compared the prevalence of atopy in 103 patients with lung cancer (a model of mucosal cancer), 51 patients with chronic obstructive pulmonary disease matched for age, sex, and smoking habits with patients with lung cancer, and 102 healthy control subjects. The authors investigated whether the IgG response to antigens presented at the mucosal level, exacerbated in atopic subjects, might inversely be decreased in patients with lung cancer. Serum IgE antibodies against five common inhalant allergens (Dermatophagoides pteronyssinus [Der p1], Aspergillus fumigatus, grass pollen, and cat and dog danders) were detected through a radioallergosorbent test assay. Serum IgG antibodies against allergens naturally presented at the mucosal level (respiratory mucosa with Der p1 and digestive mucosa with betalactoglobulin [BLG] and soya proteins [SP]) were measured through a solid phase enzyme-linked immunosorbent assay test. Atopic status was assessed in 19 patients (18.4%) with lung cancer, 9 patients (17.6%) with chronic obstructive pulmonary disease (COPD), and 18 healthy control subjects (17.6%). Distributions of specific IgG levels were represented on frequency histograms after natural logarithmic transformation and showed reduced levels of anti-Der p1 and anti-BLG IgG in the cancer population compared with the control populations but similar levels of anti-SP IgG. Influence of sex, age, smoking habits, histologic type of cancer, and its extent could be excluded. The authors' results show no difference in the prevalence of atopy between the three groups. They document a selective, rather than general, defect in the immune response initiated at the mucosal level in patients with lung cancer, the most frequent mucosal cancer in man.
以往研究表明，特应性与黏膜表面癌症之间存在负相关关系。传统上，特应性是通过检测针对吸入性过敏原的特异性免疫球蛋白E（IgE）抗体来评估的。然而，普拉茨 - 米尔斯最近提出，特应性是生物体通过不仅产生IgE，还产生免疫球蛋白A和免疫球蛋白G（IgG）抗体，来识别和应对在黏膜水平呈现的有限剂量过敏原的能力。作者比较了103例肺癌患者（黏膜癌模型）、51例年龄、性别和吸烟习惯与肺癌患者相匹配的慢性阻塞性肺疾病患者以及102名健康对照者的特应性患病率。作者研究了在特应性个体中加剧的对黏膜水平呈现抗原的IgG反应在肺癌患者中是否反而降低。通过放射变应原吸附试验检测血清中针对五种常见吸入性过敏原（屋尘螨[Der p1]、烟曲霉、草花粉以及猫和狗皮屑）的IgE抗体。通过固相酶联免疫吸附试验检测血清中针对黏膜水平自然呈现的过敏原（呼吸道黏膜中的Der p1以及消化黏膜中的β - 乳球蛋白[BLG]和大豆蛋白[SP]）的IgG抗体。在19例（18.4%）肺癌患者、9例（17.6%）慢性阻塞性肺疾病（COPD）患者以及18名健康对照者（17.6%）中评估了特应性状态。在自然对数转换后，特异性IgG水平的分布以频率直方图表示，结果显示与对照人群相比，癌症人群中抗Der p1和抗BLG IgG水平降低，但抗SP IgG水平相似。可以排除性别、年龄、吸烟习惯、癌症组织学类型及其范围的影响。作者的结果显示三组之间特应性患病率无差异。他们证明了在人类最常见的黏膜癌——肺癌患者中，在黏膜水平启动的免疫反应存在选择性而非普遍性缺陷。
