Armentia Alicia, Bartolomé Borja, Puyo Miguel, Paredes Carmen, Calderón Silvia, Asensio Teresa, del Villar Valentín
Sección de Alergia del Hospital Universitario Río Hortega, Valladolid, Spain.
Ann Allergy Asthma Immunol. 2007 Apr;98(4):329-36. doi: 10.1016/S1081-1206(10)60878-2.
Skin testing and sera measurements have verified the existence of tobacco specific IgE. However, the few published studies on this matter report conflicting results concerning their clinical significance.
To verify if a specific clinical allergenic response against tobacco might be possible in allergenic and nonallergenic bronchial diseases.
We performed a cross-sectional observational case-control analysis on 180 patients with asthma, chronic obstructive pulmonary disease (COPD), and bronchial carcinoma and controls who were randomly chosen. Skin prick tests and serum specific IgE to tobacco and related allergens, bronchial challenge with cigarettes and tobacco extract, patch tests with tobacco and nicotine, sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting, and Enzyme AllergoSorbent Test (EAST) inhibition were performed.
Twenty-eight patients had positive tobacco skin prick test results. The association among positive skin prick test results, IgE, and bronchial challenge was strong (P < .001). Tobacco sensitivity was higher in patients with pollen asthma than in patients with COPD and carcinoma and negative in patients with intrinsic asthma and controls. A positive bronchial challenge result was related to the length of habit (P < .001) and the tobacco index in patients who had stopped smoking (P < .001). Delayed bronchial and patch response was more common in patients with COPD (P < .001). Tobacco IgE response (EAST) was related to sensitivity to Lolium perenne (rye grass) pollen (P < .001) but not to other vegetables that belong to the Solanaceae family. EAST inhibition showed cross-reactivity between tobacco and Lolium pollen.
Tobacco may be responsible for a specific IgE response. Patients with pollen asthma were those with more positive responses to tobacco due to cross-reactivity between Lolium and tobacco allergens.
皮肤试验和血清检测已证实烟草特异性IgE的存在。然而，关于此事的少数已发表研究报告了其临床意义方面相互矛盾的结果。
验证在过敏性和非过敏性支气管疾病中是否可能存在针对烟草的特异性临床过敏反应。
我们对180例哮喘、慢性阻塞性肺疾病（COPD）、支气管癌患者及随机选取的对照组进行了横断面观察性病例对照分析。进行了皮肤点刺试验、血清中针对烟草及相关过敏原的特异性IgE检测、香烟和烟草提取物支气管激发试验、烟草和尼古丁斑贴试验、十二烷基硫酸钠 - 聚丙烯酰胺凝胶电泳免疫印迹以及酶联免疫吸附试验（EAST）抑制试验。
28例患者皮肤点刺试验结果为阳性。皮肤点刺试验阳性结果、IgE与支气管激发试验之间的关联很强（P < 0.001）。花粉性哮喘患者对烟草的敏感性高于COPD患者和癌症患者，内源性哮喘患者及对照组为阴性。支气管激发试验阳性结果与吸烟习惯时长（P < 0.001）及戒烟患者的烟草指数相关（P < 0.001）。COPD患者中延迟性支气管和斑贴反应更为常见（P < 0.001）。烟草IgE反应（EAST）与对黑麦草花粉的敏感性相关（P < 0.001），但与其他茄科蔬菜无关。EAST抑制试验显示烟草与黑麦草花粉之间存在交叉反应。
烟草可能引发特异性IgE反应。由于黑麦草与烟草过敏原之间的交叉反应，花粉性哮喘患者对烟草的反应更阳性。
