Matsuo H, Dahlström J, Tanaka A, Kohno K, Takahashi H, Furumura M, Morita E
Division of Clinical Pharmacotherapeutics, Graduate School of Biomedical Sciences, Hiroshima, Japan.
Allergy. 2008 Feb;63(2):233-6. doi: 10.1111/j.1398-9995.2007.01504.x.
BACKGROUND: A recent study has shown that the measurement of specific IgE antibodies to B-cell epitope peptides of wheat omega-5 gliadin (Pep A) and high molecular weight glutenin subunit (Pep B) are useful to diagnose wheat-dependent exercise-induced anaphylaxis (WDEIA). AIMS OF THE STUDY: We sought to compare the sensitivity and specificity of the in vitro tests for measuring the specific IgE antibodies to recombinant omega-5 gliadin (romega-5 gliadin) with those for wheat, gluten, Pep A, and Pep B in identification of patients with WDEIA. METHODS: Fifty patients with WDEIA, 25 healthy subjects and 25 patients with atopic dermatitis with specific IgE antibodies to wheat but without experience of allergic reactions after ingestion of wheat products were enrolled in this study. The concentrations of specific IgE antibodies were measured using ImmunoCAP. The empirical receiver operating characteristics curves (ROC) for each test were prepared and the areas under the ROC curve (AUC) were compared. RESULTS: In patients with WDEIA, the sensitivities of the allergen-specific IgE tests for wheat, gluten, Pep A, Pep B and romega-5 gliadin were 48%, 56%, 76%, 22%, and 80%, respectively. The seven of 10 WDEIA patients with no specific IgE antibodies to romega-5 gliadin had specific IgE antibodies to Pep B. The highest AUC (0.850) was observed in the test for romega-5 gliadin. CONCLUSIONS: Measuring the concentration of specific IgE antibodies to romega-5 gliadin is more useful than to wheat, gluten, or Pep A in the identification of patients with WDEIA.
背景：最近一项研究表明，检测针对小麦ω-5醇溶蛋白（肽A）和高分子量谷蛋白亚基（肽B）的B细胞表位肽的特异性IgE抗体，有助于诊断小麦依赖运动诱发的过敏反应（WDEIA）。 研究目的：我们试图比较体外检测重组ω-5醇溶蛋白（rω-5醇溶蛋白）特异性IgE抗体与检测小麦、麸质、肽A和肽B特异性IgE抗体在识别WDEIA患者方面的敏感性和特异性。 方法：本研究纳入了50例WDEIA患者、25名健康受试者和25例对小麦有特异性IgE抗体但摄入小麦制品后无过敏反应经历的特应性皮炎患者。使用免疫捕获法测量特异性IgE抗体的浓度。绘制每个检测的经验性受试者工作特征曲线（ROC），并比较ROC曲线下面积（AUC）。 结果：在WDEIA患者中，小麦、麸质、肽A、肽B和rω-5醇溶蛋白的过敏原特异性IgE检测的敏感性分别为48%、56%、76%、22%和80%。10例对rω-5醇溶蛋白无特异性IgE抗体的WDEIA患者中有7例对肽B有特异性IgE抗体。rω-5醇溶蛋白检测的AUC最高（0.850）。 结论：在识别WDEIA患者方面，检测rω-5醇溶蛋白特异性IgE抗体的浓度比检测小麦、麸质或肽A更有用。
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