乳胶 - 水果综合征的遗传基础：西班牙人群中与人类白细胞抗原II类等位基因的关联。

Genetic basis of the latex-fruit syndrome: association with HLA class II alleles in a Spanish population.

作者信息

Blanco Carlos, Sánchez-García Florentino, Torres-Galván María-José, Dumpierrez Antonio G, Almeida Lourdes, Figueroa Javier, Ortega Nancy, Castillo Rodolfo, Gallego María-Dolores, Carrillo Teresa

机构信息

Servicio de Alergia, Hospital de Gran Canaria Dr. Negrín, C/Bco de la Ballena s/n, 35012 Las Palmas de Gran Canaria, Spain.

出版信息

J Allergy Clin Immunol. 2004 Nov;114(5):1070-6. doi: 10.1016/j.jaci.2004.06.022.

DOI:10.1016/j.jaci.2004.06.022

PMID:15536412

Abstract

BACKGROUND

The latex-fruit syndrome is a well-defined disorder whose genetic background has not been elucidated.

OBJECTIVE

To study the genetic basis of the latex-fruit syndrome.

METHODS

In a case-control study, we have investigated a carefully selected group of patients allergic to latex, searching for association between latex-fruit allergy and HLA class I and II genes, HLA-DR functional groups, and markers IL4-R1 and FcepsilonRI-betaca .

RESULTS

Seventy-eight patients allergic to latex without spina bifida, 33% of them also allergic to fruits, were included in our protocol. Skin prick test results with both a commercial latex extract and purified hevein were significantly greater in patients allergic to latex and fruit than in patients allergic to latex and not fruit. A cutoff point of >7 mm for commercial latex skin prick test diagnosed latex-fruit allergy with a sensitivity of 66.7% (95% CI, 41.0-86.6) and a specificity of 83.3% (95% CI, 68.6-93.0) in our series of patients. No significant differences were found regarding HLA class I, IL4-R1 , or FcepsilonRI-betaca allele distributions. However, comparison of HLA class II allelic frequencies between patients allergic to latex and fruit and patients allergic to latex and not fruit showed significant associations of latex-fruit allergy with DQB1 *0201 (corrected P value, .001; odds ratio, 7.3; 95% CI, 2.6-20.0), as well as with HLA-DR functional group E (corrected P value, .028; odds ratio, 16.0; 95% CI, 1.9-134.1). When comparing allelic distribution among different subgroups of patients allergic to latex, additional significant associations of latex-fruit allergy with DRB1 *0301 and *0901, and of latex and not fruit allergy with DQB1 *0202, DRB1 *0701 and *1101, were demonstrated.

CONCLUSIONS

Latex-fruit allergy is associated with HLA-DQB1 *0201, DRB1 *0301, and *0901, as well as with HLA-DR functional group E, whereas latex-not-fruit allergy is associated with DQB1 *0202, and with both DRB1 *0701 and *1101 alleles.

摘要

背景

乳胶-水果综合征是一种已明确的疾病，但其遗传背景尚未阐明。

目的

研究乳胶-水果综合征的遗传基础。

方法

在一项病例对照研究中，我们对精心挑选的一组乳胶过敏患者进行了调查，以寻找乳胶-水果过敏与HLA I类和II类基因、HLA-DR功能组以及白细胞介素4受体1（IL4-R1）和高亲和力IgE受体β链（FcepsilonRI-betaca）标记物之间的关联。

结果

78例无脊柱裂的乳胶过敏患者被纳入我们的研究方案，其中33%也对水果过敏。对乳胶和水果过敏的患者，使用商业乳胶提取物和纯化的橡胶素进行皮肤点刺试验的结果显著高于仅对乳胶过敏的患者。在我们的患者系列中，商业乳胶皮肤点刺试验>7 mm的截断值诊断乳胶-水果过敏的敏感性为66.7%（95%可信区间，41.0 - 86.6），特异性为83.3%（95%可信区间，68.6 - 93.0）。在HLA I类、IL4-R1或FcepsilonRI-betaca等位基因分布方面未发现显著差异。然而，对乳胶和水果过敏的患者与仅对乳胶过敏的患者之间HLA II类等位基因频率的比较显示，乳胶-水果过敏与DQB1 *0201显著相关（校正P值，.001；比值比，7.3；95%可信区间，2.6 - 20.0），也与HLA-DR功能组E相关（校正P值，.028；比值比，16.0；95%可信区间，1.9 - 134.1）。在比较不同乳胶过敏患者亚组之间的等位基因分布时，还显示乳胶-水果过敏与DRB1 0301和0901显著相关，而仅乳胶过敏与DQB1 *0202、DRB1 0701和1101显著相关。