Michel S, Yawalkar N, Schnyder B, Fischer B, Helbling A
University Clinic for Rheumatology and Clinical Immunology/Allergology, Inselspital, University of Bern, Switzerland.
J Investig Allergol Clin Immunol. 2009;19(3):173-9.
Aeroallergens from house dust mite (HDM) may be an important trigger in a subgroup of patients with atopic dermatitis (AD). HDM and cockroach (CR) contain cross-reactive allergens, such as tropomyosin.
To investigate the diagnostic value of patch testing with an aeroallergen and the role of CR allergen and HDM allergen in persons with AD.
We performed skin prick tests (SPT) with a panel of common aeroallergens and total serum immunoglobulin (Ig)E and specific IgE tests for CR and HDM on 23 patients with AD and 9 nonatopic control participants. Atopy patch tests (APT) were performed with CR and HDM extracts on clinically uninvolved skin on the back, and evaluated after 48 and 72 hours.
A positive APT reaction to CR was found in 10/23 (43%) patients with AD. No positive reactions were observed in the nonatopic control participants. Positive APT reactions for CR showed no significant correlation with SPT or specific IgE levels for this allergen. Twelve of the 23 (52%) patients with AD were also sensitized to HDM. There was no significant correlation between positive results for SPT, APT, and specific IgE to CR and HDM.
We demonstrate that CR allergens can induce positive patch test reactions in patients with AD. The absence of a significant correlation to SPT and specific IgE antibodies suggests that T-cell- and IgE-sensitization may be mediated by different allergens. There was no significant relationship between CR and HDM sensitivity, thus indicating no major cross-reactivity.
屋尘螨（HDM）的气传变应原可能是特应性皮炎（AD）患者亚组中的一个重要触发因素。HDM和蟑螂（CR）含有交叉反应性变应原，如原肌球蛋白。
探讨气传变应原斑贴试验的诊断价值以及CR变应原和HDM变应原在AD患者中的作用。
我们对23例AD患者和9名非特应性对照参与者进行了一组常见气传变应原的皮肤点刺试验（SPT）、总血清免疫球蛋白（Ig）E以及CR和HDM的特异性IgE检测。用CR和HDM提取物在背部临床上未受累的皮肤上进行特应性斑贴试验（APT），并在48小时和72小时后进行评估。
23例AD患者中有10例（43%）对CR的APT反应呈阳性。在非特应性对照参与者中未观察到阳性反应。CR的阳性APT反应与该变应原的SPT或特异性IgE水平无显著相关性。23例AD患者中有12例（52%）也对HDM致敏。SPT、APT以及CR和HDM特异性IgE的阳性结果之间无显著相关性。
我们证明CR变应原可在AD患者中诱导阳性斑贴试验反应。与SPT和特异性IgE抗体无显著相关性表明T细胞致敏和IgE致敏可能由不同变应原介导。CR和HDM敏感性之间无显著关系，因此表明不存在主要的交叉反应性。
