Liang Kai-Li, Su Mao-Chang, Jiang Rong-San
Department of Otolaryngology, Taichung Veterans General Hospital, Taiwan, ROC.
J Chin Med Assoc. 2006 Jan;69(1):3-6. doi: 10.1016/S1726-4901(09)70103-0.
Mold is ubiquitous in our environment and is a common allergen in allergic diseases. The skin test and the Pharmacia ImmunoCAP system (CAP) for assay-specific immunoglobulin E (IgE) antibodies are both widely used. The goal of this study was to compare the performance of the skin test and CAP in the evaluation of mold allergy.
Patients with allergic rhinitis were enrolled at our outpatient department. The diagnosis of allergic rhinitis was based on typical symptoms for more than 2 years. All patients were tested by both intradermal skin test and serum assay for specific IgE antibodies. The skin test included house dust, cotton, ragweed, and 5 fungal antigens (Candida, Alternaria, Aspergillus, Cladosporium, and Penicillium). The serum-specific IgE antibodies were quantified using the radioimmunoassay version of CAP.
Seventy-five patients (44 males and 31 females) with allergic rhinitis were enrolled in this study. Their ages ranged from 12 to 76 years old, with a mean of 31.9 years. The positive rates of skin test and CAP were 56.0% versus 9.3% for Candida, 22.7% versus 1.3% for Alternaria, 16% versus 9.3% for Aspergillus, 14.7% versus 1.3% for Cladosporium, and 32% versus 8% for Penicillium. There were statistically significant differences between the positive rates for Candida, Alternaria, Cladosporium, and Penicillium when analyzed by the McNemar test.
The positive rate of the skin test is higher than CAP when evaluating mold allergy. Clinicians should note that a discrepancy may exist between the results of in vitro and in vivo tests when evaluating mold allergy.
霉菌在我们的环境中无处不在，是过敏性疾病中常见的变应原。皮肤试验和用于检测特异性免疫球蛋白E（IgE）抗体的法玛西亚免疫捕获系统（CAP）都被广泛使用。本研究的目的是比较皮肤试验和CAP在评估霉菌过敏方面的性能。
在我们的门诊部招募过敏性鼻炎患者。过敏性鼻炎的诊断基于2年以上的典型症状。所有患者均接受皮内皮肤试验和血清特异性IgE抗体检测。皮肤试验包括屋尘、棉花、豚草和5种真菌抗原（白色念珠菌、链格孢属、曲霉属、枝孢属和青霉属）。使用CAP的放射免疫分析版本对血清特异性IgE抗体进行定量。
本研究共纳入75例过敏性鼻炎患者（44例男性和31例女性）。他们的年龄在12至76岁之间，平均年龄为31.9岁。白色念珠菌皮肤试验和CAP的阳性率分别为56.0%和9.3%，链格孢属分别为22.7%和1.3%，曲霉属分别为16%和9.3%，枝孢属分别为14.7%和1.3%，青霉属分别为32%和8%。通过McNemar检验分析，白色念珠菌、链格孢属、枝孢属和青霉属的阳性率之间存在统计学显著差异。
在评估霉菌过敏时，皮肤试验的阳性率高于CAP。临床医生应注意，在评估霉菌过敏时，体外和体内试验结果可能存在差异。
