Toncić Ruzica Jurakić, Lipozencić Jasna
University Department of Dermatology and Venereology, Zagreb University Hospital Center, Zagreb, Croatia.
Acta Med Croatica. 2011;65(2):97-106.
The aim of the article is to introduce the atopy patch test (APT) as a model of cellular immunity reaction. APT is epicutaneous test performed with food and aeroallergens, and represents a good model for T lymphocyte hypersensitivity. It is compared with skin prick test (SPT). Its value is supported by the fact that atopic dermatitis is the result of complex immune interactions and involves both Coombs and Gell reactions type IV and I. In this review, we shortly discuss the etiopathogenesis of atopic dermatitis, distinction of extrinsic and intrinsic issues, and compare the value of APT with SPT and IgE determination. APT includes epicutaneous application of type I allergens known to elicit IgE mediated reactions, followed by evaluation of eczematous skin reaction after 48 and 72 hours. The limitations of ATP include the lack of test standardization, but there also are comparative advantages over SPT and specific IgE determination. We also briefly discuss the most important food and aeroallergens. APT has been recognized as a diagnostic tool in the evaluation of food allergy and aeroallergens such as house dust mite, pollen and animal dander. APT is a useful diagnostic procedure in patients with atopic dermatitis allergic to inhalant allergens and in children with food allergy younger than 2 years. The sensitivity and specificity of the test greatly depend on the allergen tested and patient age.
本文旨在介绍特应性斑贴试验(APT)作为一种细胞免疫反应模型。APT是一种用食物和吸入性变应原进行的表皮试验,是T淋巴细胞超敏反应的良好模型。它与皮肤点刺试验(SPT)进行了比较。其价值得到了支持,因为特应性皮炎是复杂免疫相互作用的结果,涉及库姆斯和盖尔IV型和I型反应。在本综述中,我们简要讨论了特应性皮炎的病因发病机制、外源性和内源性问题的区分,并比较了APT与SPT及IgE测定的价值。APT包括表皮应用已知能引发IgE介导反应的I型变应原,然后在48小时和72小时后评估湿疹性皮肤反应。ATP的局限性包括缺乏试验标准化,但与SPT和特异性IgE测定相比也有比较优势。我们还简要讨论了最重要的食物和吸入性变应原。APT已被公认为评估食物过敏和吸入性变应原(如屋尘螨、花粉和动物皮屑)的诊断工具。APT对特应性皮炎合并吸入性变应原过敏的患者以及2岁以下食物过敏的儿童是一种有用的诊断方法。该试验的敏感性和特异性很大程度上取决于所检测的变应原和患者年龄。