Pittner G, Vrtala S, Thomas W R, Weghofer M, Kundi M, Horak F, Kraft D, Valenta R
Division of Immunopathology, Department of Pathophysiology, Vienna General Hospital, Medical University of Vienna, Austria.
Clin Exp Allergy. 2004 Apr;34(4):597-603. doi: 10.1111/j.1365-2222.2004.1930.x.
Mites belong to the most frequent and potent allergen sources. Immunotherapy with mite allergen extracts is frequently performed if allergen avoidance is not possible or successful. However, highly controversial results have been reported for mite-specific immunotherapy.
The aim of this study was to develop diagnostic concepts that may contribute to an improved selection of patients for immunotherapy with Der p allergen extracts and that may be used for immunological monitoring of patients undergoing this treatment.
The IgE reactivity profiles to Der p extract were determined in a Middle European mite-allergic population by IgE immunoblotting and by using a panel of seven purified natural or recombinant Der p allergens (nDer p 1, nDer p 4, rDer p 2, rDer p 5, rDer p 7, rDer p 8, rDer p 10). Furthermore, we investigated the sensitization and cross-reactivity to house-dust- and storage-mite allergen extracts by CAP FEIA measurements and by IgE competition studies.
More than 95% of the patients could be diagnosed with a combination of nDer p 1 and rDer p 2. With the methods used, we could discriminate mite-allergic patients who were mainly sensitized to the major Der p allergens (Der p 1, Der p 2) from patients with a broad sensitization profile, including highly cross-reactive allergens (e.g. Der p 10: tropomyosin) as well as reactivity to storage mites.
Diagnostic tests containing the major mite allergens (i.e. Der p 1, Der p 2) and highly cross-reactive mite allergens (e.g. Der p 10) may improve the diagnostic selection of patients for immunotherapy with Der p extracts. These tests may also be used for the immunological monitoring of patients undergoing immunotherapy.
螨虫是最常见且强效的过敏原来源之一。如果无法避免或成功避免接触过敏原，通常会采用螨虫过敏原提取物进行免疫治疗。然而，关于螨虫特异性免疫治疗的结果存在高度争议。
本研究的目的是开发诊断方法，以有助于更好地选择接受Der p过敏原提取物免疫治疗的患者，并可用于对接受该治疗的患者进行免疫监测。
通过IgE免疫印迹法以及使用一组七种纯化的天然或重组Der p过敏原（nDer p 1、nDer p 4、rDer p 2、rDer p 5、rDer p 7、rDer p 8、rDer p 10），在中欧螨虫过敏人群中测定对Der p提取物的IgE反应性谱。此外，我们通过CAP FEIA测量和IgE竞争研究，调查了对屋尘螨和仓储螨过敏原提取物的致敏和交叉反应性。
超过95%的患者可以通过nDer p 1和rDer p 2的组合进行诊断。使用这些方法，我们可以区分主要对主要Der p过敏原（Der p 1、Der p 2）致敏的螨虫过敏患者和具有广泛致敏谱的患者，后者包括高度交叉反应的过敏原（如Der p 10：原肌球蛋白）以及对仓储螨的反应性。
包含主要螨虫过敏原（即Der p 1、Der p 2）和高度交叉反应的螨虫过敏原（如Der p 10）的诊断测试可能会改善接受Der p提取物免疫治疗患者的诊断选择。这些测试也可用于对接受免疫治疗患者的免疫监测。
