Wöhrl S, Vigl K, Zehetmayer S, Hiller R, Jarisch R, Prinz M, Stingl G, Kopp T
Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria.
Allergy. 2006 May;61(5):633-9. doi: 10.1111/j.1398-9995.2006.01078.x.
Currently, the diagnosis of IgE-mediated allergy is based on allergen-specific history and diagnostic procedures using natural allergen extracts for in vivo and in vitro tests.
The aim of the study was to comparatively analyse a new component-based allergen-microarray and the 'quasi-standard' ImmunoCAP for their clinical relevance in patients with allergic rhinoconjunctivitis to five aeroallergens [house dust mite (HDM), cat dander, birch, grass and mugwort pollen] in a prospective, double-centre study.
We enrolled 120 subjects at the two study centres. Allergic patients were defined as having an allergen-specific history plus a concomitant positive skin-prick test (SPT) to natural allergen extracts and specific serum IgE was measured by both methods. Each allergen was analysed separately.
The microarray performed equally well in receiver-operating characteristic curve (ROC) analyses when compared with the CAP in cat (23 allergic vs 97 non-allergic, ROC area under the curve microarray 0.950 vs CAP 0.894, P = 0.211), birch (31/89, 0.908 vs 0.878, P = 0.483) and grass pollen (47/73, 0.923 vs 0.915, P = 0.770). It was slightly less sensitive in HDM-allergic subjects (26 allergic vs 94 non-allergic, ROC area microarray 0.808 vs CAP 0.911, P = 0.053) and displayed a reduced sensitivity in the mugwort pollen-allergic patients (17/103, 0.723 vs 0.879, P = 0.032).
Component-based testing and the whole-allergen CAP are equally relevant in the diagnosis of grass-, birch- and cat-allergic patients. Although slightly less sensitive, the microarray is sufficient for the diagnosis of HDM-allergic patients, but needs alternative and/or additional components for detecting mugwort allergy.
目前，IgE介导的过敏症诊断基于过敏原特异性病史以及使用天然过敏原提取物进行体内和体外检测的诊断程序。
本研究旨在通过一项前瞻性、双中心研究，比较一种新型的基于组分的过敏原微阵列和“准标准”免疫捕获法（ImmunoCAP）在过敏性鼻结膜炎患者中对五种气传过敏原（屋尘螨、猫毛屑、桦树、草和艾蒿花粉）的临床相关性。
我们在两个研究中心招募了120名受试者。过敏患者定义为具有过敏原特异性病史，同时对天然过敏原提取物进行皮肤点刺试验（SPT）呈阳性，并通过两种方法测量特异性血清IgE。每种过敏原分别进行分析。
与免疫捕获法（CAP）相比，微阵列在猫（23名过敏患者对97名非过敏患者，微阵列曲线下面积0.950，CAP为0.894，P = 0.211）、桦树（31/89，0.908对0.878，P = 0.483）和草花粉（47/73，0.923对0.915，P = 0.770）的受试者工作特征（ROC）分析中表现相当。在屋尘螨过敏受试者中，其敏感性略低（26名过敏患者对94名非过敏患者，微阵列曲线下面积0.808，CAP为0.911，P = 0.053），在艾蒿花粉过敏患者中敏感性降低（17/103，0.723对0.879，P = 0.032）。
基于组分的检测和全过敏原免疫捕获法（CAP）在草、桦树和猫过敏患者的诊断中同样具有相关性。尽管敏感性略低，但微阵列足以诊断屋尘螨过敏患者，但需要替代和/或额外的组分来检测艾蒿过敏。
