Department of Medicine, Clinical Immunology and Allergy Unit, Karolinska Institutet and University Hospital, Stockholm, Sweden.
Pediatr Allergy Immunol. 2010 Mar;21(2 Pt 1):277-83. doi: 10.1111/j.1399-3038.2009.00894.x. Epub 2009 Dec 7.
Exposure to cat is one of the most important causes of allergic disease. The objective of this study was to investigate IgE reactivity to the recombinant major cat allergen, rFel d 1, as an early marker of cat sensitization. Based on questionnaires, 144 children with allergic symptoms due to cat, or where such symptoms were suspected, were selected from the birth cohort BAMSE and allocated into three study groups. Blood samples taken at age 4 and 8 yrs were analysed for IgE to rFel d 1 and cat dander extract (CDE) by quantitative ELISA (cut-off limit 0.037 kU(A)/l) and the ImmunoCAP System (cut-off limit 0.35 kU(A)/l), respectively. At 4 yrs, 25/33 children with certain allergic symptoms to cat had IgE to both rFel d 1 and CDE, while 14/42 of those suspecting symptoms at 4 had IgE to rFel d 1 and 9/42 to CDE. In a group developing symptoms after 4 yrs, 60/69 had IgE to rFel d 1 and 57/69 to CDE at 8, while 33/69 had IgE to rFel d 1 already at 4 and 26/69 to CDE. This was the only one of the three study groups where a significant increase in the IgE levels to rFel d 1 was found from 4 to 8 yrs (p < 0.001), even when only children with IgE to rFel d 1 already at 4 were included (p < 0.001). We show that the single major cat allergen rFel d 1 is at least as good as CDE in the diagnosis of cat allergy in childhood. With a sensitive rFel d 1 assay cat sensitization can be detected several years before symptoms to cat are reported.
接触猫是引起过敏疾病的最重要原因之一。本研究的目的是研究重组猫主要过敏原 rFel d 1 的 IgE 反应，作为猫过敏的早期标志物。根据问卷调查，从 BAMSE 出生队列中选择了 144 名因猫而出现过敏症状或怀疑有此类症状的儿童，并将其分为三组研究。在 4 岁和 8 岁时采集血样，通过定量 ELISA（0.037 kU(A)/l 为截断值）和 ImmunoCAP 系统（0.35 kU(A)/l 为截断值）分析 rFel d 1 和猫皮屑提取物（CDE）的 IgE。在 4 岁时，33/33 名有明确猫过敏症状的儿童 rFel d 1 和 CDE 的 IgE 均为阳性，而 42/42 名怀疑有症状的儿童中 14/42 名 rFel d 1 的 IgE 为阳性，9/42 名 CDE 的 IgE 为阳性。在 4 岁后出现症状的一组中，69/69 名儿童 rFel d 1 的 IgE 为阳性，69/69 名儿童 CDE 的 IgE 为阳性，而 69/69 名儿童 rFel d 1 的 IgE 为阳性，69/69 名儿童 CDE 的 IgE 为阳性。这是三组研究中唯一一组从 4 岁到 8 岁 rFel d 1 的 IgE 水平显著增加（p <0.001）的组，即使仅包括在 4 岁时已经存在 rFel d 1 的 IgE 的儿童也是如此（p <0.001）。我们表明，在儿童时期，单一的主要猫过敏原 rFel d 1 与 CDE 一样，可用于诊断猫过敏。使用灵敏的 rFel d 1 检测，可在报告猫过敏症状前数年检测到猫过敏。
