Taketomi E A, Silva D A O, Sopelete M C, Gervásio A M, Alves R, Sung S J
Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlândia, Brazil.
J Investig Allergol Clin Immunol. 2006;16(2):104-9.
Several studies have shown that the presence of IgE antibodies to house dust mites (HDM), particularly Dermatophagoides pteronyssinus (Dpt), is an important risk factor for asthma. Allergen immunotherapy is indicated for patients with IgE antibodies to clinically relevant allergens. The aims of this study were to analyze the levels of specific serum IgE to Der p 1 and Der p 2 allergens in mite-sensitized atopic patients and to compare them with both in vivo (skin prick test) and in vitro (IgE-ELISA) sensitizations to Dpt crude extract. Forty-seven atopic patients with allergic rhinitis with or without intermittent or persistent mild asthma and positive skin prick test (SPT) to Dpt total extract were studied. Thirty age-matched healthy subjects with negative SPT to HDM were included as controls. Levels of total IgE and Dpt-, Der p 1- and Der p 2-specific IgE were measured by ELISAs in SPT-positive atopic patients and SPT-negative control subjects. Among 47 symptomatic atopic patients, 27 (57.4%) were double positive IgE to Der p 1 and Der p 2 allergens, 3 (6.4%) were single positive IgE to Der p 1, 4 (8.5%) were single positive IgE to Der p 2, and 13 (27.6%) were double negative IgE to both allergens. There was a significant correlation between Der p 1- and Der p 2-specific IgE levels, but not between Der p 1- or Der p 2-IgE levels and SPT results. The double negative IgE patients had the smallest skin test reactions although they showed high mean levels of total serum IgE. Therefore, the knowledge of specific IgE levels to Der p 1 and Der p 2 major allergens might support physicians for indication or follow-up in mite-sensitized patients under allergen-specific immunotherapy. These approaches might be important for obtaining improved safety and efficacy of the current clinical practice of allergen immunotherapy.
多项研究表明，存在针对屋尘螨（HDM）的IgE抗体，尤其是针对粉尘螨（Dpt）的抗体，是哮喘的一个重要危险因素。变应原免疫疗法适用于对临床相关变应原产生IgE抗体的患者。本研究的目的是分析螨致敏的特应性患者中针对Der p 1和Der p 2变应原的特异性血清IgE水平，并将其与对Dpt粗提物的体内（皮肤点刺试验）和体外（IgE-ELISA）致敏情况进行比较。对47例患有变应性鼻炎且伴有或不伴有间歇性或持续性轻度哮喘、对Dpt总提取物皮肤点刺试验（SPT）呈阳性的特应性患者进行了研究。纳入30名年龄匹配、对HDM皮肤点刺试验阴性的健康受试者作为对照。通过ELISA法测定了SPT阳性的特应性患者和SPT阴性对照受试者的总IgE以及Dpt、Der p 1和Der p 2特异性IgE水平。在47例有症状的特应性患者中，27例（57.4%）对Der p 1和Der p 2变应原的IgE呈双阳性，3例（6.4%）对Der p 1的IgE呈单阳性，4例（8.5%）对Der p 2的IgE呈单阳性，13例（27.6%）对两种变应原的IgE均呈双阴性。Der p 1和Der p 2特异性IgE水平之间存在显著相关性，但Der p 1或Der p 2 - IgE水平与SPT结果之间无相关性。双阴性IgE患者的皮肤试验反应最小，尽管他们的血清总IgE平均水平较高。因此，了解针对Der p 1和Der p 2主要变应原的特异性IgE水平可能有助于医生对接受变应原特异性免疫疗法的螨致敏患者进行适应证判断或随访。这些方法对于提高变应原免疫疗法当前临床实践的安全性和有效性可能很重要。
