Matsui E C, Diette G B, Krop E J M, Aalberse R C, Smith A L, Curtin-Brosnan J, Eggleston P A
Johns Hopkins University, Baltimore, MD 21287, USA.
Clin Exp Allergy. 2005 Oct;35(10):1347-53. doi: 10.1111/j.1365-2222.2005.02331.x.
High levels of allergen-specific IgG have been associated with clinical efficacy in immunotherapy studies, but whether this antibody isotype is associated with clinical tolerance in the setting of environmental exposure remains unclear.
To determine if mouse allergen-specific IgG (mIgG) and IgG4 (mIgG4) levels are associated with mouse-related symptoms among IgE-sensitized laboratory workers.
Fifty-eight workers with either skin test or serologic evidence of IgE-mediated mouse sensitization were studied. Symptom data were obtained by a questionnaire. Serum levels of mouse-specific IgG, IgG4, and IgE were quantified by a solid-phase antigen-binding assay (IgG) and RAST (IgG4 and IgE), and the relationships between mouse-specific serologic responses and mouse-related symptoms were analysed.
Twenty-three (39.7%) participants reported mouse-related symptoms. Mouse-specific IgG and IgG4 levels were not associated with mouse-related symptoms among the study population as a whole. Among the 29 (50%) participants with detectable mouse-specific IgE (mIgE), higher mouse-specific IgG and IgG4 levels were associated with a decreased risk of symptoms, after adjusting for mIgE level (odds ratio (OR) 0.3, 95% confidence interval (CI): 0.1-1.4, and OR 0.3, 95% CI: 0.04-2.6, respectively). Higher levels of mIgG and mIgG4 remained associated with a decreased risk of symptoms after additional adjustment for sex and handling of mice (OR 0.1, 95% CI: 0.02-0.7, and OR 0.2, 95% CI: 0.02-2.1, respectively). Higher mIgG : IgE and mIgG4 : IgE ratios were also associated with a decreased risk of symptoms after adjusting for these confounders (OR 0.1, 95% CI: 0.02-0.7, and OR 0.2, 95% CI: 0.02-0.92, respectively).
Among workers with detectable mIgE, higher mIgG and mIgG4 levels are associated with a decreased risk of mouse-related symptoms. High serum levels of mIgG or mIgG4 may be markers for clinical tolerance among laboratory mouse workers with detectable mIgE, but these findings need to be confirmed in larger, prospective studies.
在免疫治疗研究中，高水平的过敏原特异性IgG与临床疗效相关，但在环境暴露情况下，这种抗体亚型是否与临床耐受性相关尚不清楚。
确定在IgE致敏的实验室工作人员中，小鼠过敏原特异性IgG（mIgG）和IgG4（mIgG4）水平是否与小鼠相关症状有关。
对58名有皮肤试验或血清学证据表明存在IgE介导的小鼠致敏的工作人员进行了研究。通过问卷调查获取症状数据。采用固相抗原结合试验（IgG）和放射变应原吸附试验（RAST）（IgG4和IgE）对小鼠特异性IgG、IgG4和IgE的血清水平进行定量，并分析小鼠特异性血清反应与小鼠相关症状之间的关系。
23名（39.7%）参与者报告有小鼠相关症状。在整个研究人群中，小鼠特异性IgG和IgG4水平与小鼠相关症状无关。在29名（50%）可检测到小鼠特异性IgE（mIgE）的参与者中，在调整mIgE水平后，较高的小鼠特异性IgG和IgG4水平与症状风险降低相关（优势比（OR）分别为0.3，95%置信区间（CI）：0.1 - 1.4；OR为0.3，95%CI：0.04 - 2.6）。在进一步调整性别和小鼠处理因素后，较高水平的mIgG和mIgG4仍与症状风险降低相关（OR分别为0.1，95%CI：0.02 - 0.7；OR为0.2，95%CI：0.02 - 2.1）。在调整这些混杂因素后，较高的mIgG:IgE和mIgG4:IgE比值也与症状风险降低相关（OR分别为0.1，95%CI：0.02 - 0.7；OR为0.2，95%CI：0.02 - 0.92）。
在可检测到mIgE的工作人员中，较高的mIgG和mIgG4水平与小鼠相关症状风险降低相关。血清中高水平的mIgG或mIgG4可能是可检测到mIgE的实验室小鼠工作人员临床耐受性的标志物，但这些发现需要在更大规模的前瞻性研究中得到证实。
