Grönlund H, Adédoyin J, Reininger R, Varga E-M, Zach M, Fredriksson M, Kronqvist M, Szepfalusi Z, Spitzauer S, Grönneberg R, Valenta R, Hedlin G, van Hage M
Department of Medicine, Clinical Immunology and Allergy Unit, Karolinska Institutet and University Hospital, Stockholm, Sweden.
Clin Exp Allergy. 2008 Aug;38(8):1275-81. doi: 10.1111/j.1365-2222.2008.03003.x. Epub 2008 May 12.
Current diagnosis of allergy and asthma to cat is confirmed using cat dander extract (CDE). We have previously engineered a recombinant major cat allergen, rFel d 1, with properties identical to the natural molecule.
The aim of the study was to evaluate IgE and IgG4 antibodies to rFel d 1 among sera from cat-allergic children and adults suffering from asthma and/or rhinoconjunctivitis (RC) in populations from Sweden and Austria.
Cat-allergic children and adults from Sweden (n=27 and 31, respectively) and Austria (n=41 and 41) with RC and/or asthma were selected. Sera were tested for IgE and IgG4 antibodies to CDE and rFel d 1 by CAP, and IgE to rFel d 1 by ELISA. Healthy subjects and non-cat-allergic patients (n=75) were included as controls.
There was a high correlation between IgE responses to rFel d 1 and CDE among the 140 patients (r(s)=0.85, P<0.001); however, measured levels to rFel d 1 were on average 30% higher (P<0.0001). Ninety-eight percent of patients and none of the controls showed IgE to rFel d 1 and there was a threefold increased risk of asthma for half of the children with the highest IgE levels [odds ratio 3.23; 95% confidence interval (CI), 1.19-8.79] by ELISA. IgE responses to rFel d 1 among children with asthma were higher (median 19.4 kU/L) compared with children with RC (median 6.6 kU/L, P<0.05) and adults with asthma (median 3.0 kU/L, P<0.01). Furthermore, children with asthma displayed higher IgG4 levels than the asthmatic adults.
A single recombinant molecule, rFel d 1, is at least as sensitive for in vitro diagnostics of cat allergy as the current extract-based test. Elevated IgE antibody levels to Fel d 1 are suggested to be a risk factor for asthma in cat-allergic children.
目前对猫过敏和哮喘的诊断是使用猫皮屑提取物（CDE）来确定的。我们之前构建了一种重组主要猫过敏原rFel d 1，其性质与天然分子相同。
本研究旨在评估瑞典和奥地利人群中对猫过敏的患有哮喘和/或鼻结膜炎（RC）的儿童及成人血清中针对rFel d 1的IgE和IgG4抗体。
选取来自瑞典（分别为27名儿童和31名成人）和奥地利（41名儿童和41名成人）患有RC和/或哮喘的对猫过敏的儿童及成人。通过CAP检测血清中针对CDE和rFel d 1的IgE和IgG4抗体，通过ELISA检测针对rFel d 1的IgE。纳入健康受试者和非对猫过敏的患者（75名）作为对照。
140名患者中，对rFel d 1和CDE的IgE反应之间存在高度相关性（r(s)=0.85，P<0.001）；然而，rFel d 1的检测水平平均高30%（P<0.0001）。98%的患者对rFel d 1显示出IgE，而所有对照均未显示。通过ELISA检测，IgE水平最高的半数儿童患哮喘的风险增加了两倍[比值比3.23；95%置信区间（CI），1.19 - 8.79]。哮喘儿童对rFel d 1的IgE反应更高（中位数19.4 kU/L），相比之下，患有RC的儿童（中位数6.6 kU/L，P<0.05）和患有哮喘的成人（中位数3.0 kU/L，P<0.01）。此外，哮喘儿童的IgG4水平高于哮喘成人。
单一重组分子rFel d 1在猫过敏的体外诊断中至少与当前基于提取物的检测一样敏感。提示对Fel d 1的IgE抗体水平升高是猫过敏儿童患哮喘的一个危险因素。
