Asero R, Wopfner N, Gruber P, Gadermaier G, Ferreira F
Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano (MI), Italy.
Clin Exp Allergy. 2006 May;36(5):658-65. doi: 10.1111/j.1365-2222.2006.02477.x.
Ragweed and mugwort have nearly identical flowering periods. Clinical and serological studies showed that ragweed and mugwort sensitization are often associated and this poses relevant clinical problems in patients for whom specific immunotherapy is warranted.
To establish whether the concurrent ragweed and mugwort pollen hypersensitivity is the result of co-sensitization or of co-recognition by using purified recombinant allergens.
Sensitization to ragweed and mugwort pollen was assessed by skin prick test (SPT) in all patients reporting allergic symptoms in August and September. IgE reactivity of sera from 42 patients (26 Amb+/Art+, 14 Amb+/Art-, and two Amb-/Art+) to ragweed and mugwort pollen extract as well as to several recombinant ragweed (rAmb a 1, rAmb a 5, rAmb a 6, rAmb a 8, rAmb a 9, and Amb a 10) and mugwort (rArt v 1, rArt v 4, rArt v 5, rArt v 6, and three EF-hand calcium-binding protein) allergens was detected by dot-blot and ELISA analyses.
IgE reactivity of 372 weed pollen-allergic patients was studied. Mugwort reactivity was strongly associated with ragweed hypersensitivity: only 10/147 (7%) mugwort-hypersensitive patients were not sensitized to ragweed, whereas 225/362 (62%) ragweed-hypersensitive patients were not sensitized to mugwort. In vitro, 90% of ragweed-allergic patients reacted with rAmb a 1. Reactivity to other ragweed allergens ranged between 20% and 35%. Forty-six percent of the mugwort-sensitized patients recognized rArt v 1%, 25% reacted to Art v 4, Art v 5, and Art v 6, and 7% recognized the three-EF hand calcium-binding protein. Immunoblot inhibition experiments showed that pre-incubation with ragweed pollen extract only weakly decreased IgE reactivity to mugwort allergens.
Patients showing both ragweed- and mugwort-positive SPT and/or RAST are co-sensitized. Future studies will establish whether IgE reactivity translates into clinical symptoms and, hence, if co-sensitized patients should undergo specific immunotherapy with extracts of both mugwort and ragweed pollen.
豚草和艾蒿的花期几乎相同。临床和血清学研究表明，豚草和艾蒿致敏常常相关，这给需要进行特异性免疫治疗的患者带来了相关临床问题。
通过使用纯化的重组变应原，确定豚草和艾蒿花粉同时过敏是共同致敏还是共同识别的结果。
对所有在8月和9月报告有过敏症状的患者进行皮肤点刺试验（SPT），以评估对豚草和艾蒿花粉的致敏情况。通过斑点印迹和ELISA分析检测42例患者（26例豚草阳性/艾蒿阳性、14例豚草阳性/艾蒿阴性和2例豚草阴性/艾蒿阳性）血清对豚草和艾蒿花粉提取物以及几种重组豚草（rAmb a 1、rAmb a 5、rAmb a 6、rAmb a 8、rAmb a 9和Amb a 10）和艾蒿（rArt v 1、rArt v 4、rArt v 5、rArt v 6和三种EF手型钙结合蛋白）变应原的IgE反应性。
研究了372例杂草花粉过敏患者的IgE反应性。艾蒿反应性与豚草过敏密切相关：仅10/147（7%）艾蒿过敏患者对豚草未致敏，而225/362（62%）豚草过敏患者对艾蒿未致敏。在体外，90%的豚草过敏患者与rAmb a 1发生反应。对其他豚草变应原的反应性在20%至35%之间。46%的艾蒿致敏患者识别rArt v 1，25%对Art v 4、Art v 5和Art v 6发生反应，7%识别三种EF手型钙结合蛋白。免疫印迹抑制实验表明，用豚草花粉提取物预孵育仅微弱降低对艾蒿变应原的IgE反应性。
皮肤点刺试验和/或放射性变应原吸附试验显示豚草和艾蒿均呈阳性的患者为共同致敏。未来的研究将确定IgE反应性是否转化为临床症状，以及因此共同致敏的患者是否应接受艾蒿和豚草花粉提取物的特异性免疫治疗。
