Department of Paediatric, Dermatology and Allergology, Catholic Children's Hospital, Hamburg, Germany.
J Eur Acad Dermatol Venereol. 2014 Jan;28(1):100-7. doi: 10.1111/jdv.12083. Epub 2013 Jan 10.
Children suffering from atopic dermatitis frequently show allergen-specific sensitization. However, the corresponding IgE-recognition patterns have not yet been extensively characterized using multiallergen microarrays.
To provide comprehensive, molecular IgE repertoires in paediatric patients with atopic dermatitis using microarray technology.
Sera of 140 affected children were screened with a protein microarray containing a panel of 95 inhalant, food and staphylococcal antigen components. In addition, total serum IgE levels and further clinical parameters were recorded.
At a mean total IgE level of 1528 kU/L, the number of sensitizations varied from 0 to 32 per patient, and regression analysis revealed a significant association between total IgE and the quantity of recognized antigens. A total of 78 single allergen and microbial components elicited at least one IgE response, while 11 plant and 13 non-plant molecules were recognized by more than 10% of patients. Specific IgE against Staphylococcus aureus could be detected in 14% of children. Sensitization rates against the studied allergen molecules differed significantly when stratified by age. Whereas reactivity against inhalant allergens and SEC was lowest in the youngest group (<24 months) reaching highest values in children ≥ 72 months, IgE responses against food allergen components peaked in younger age groups (0-48 months) and clearly declined in patients of higher age. The large amount of microarray data could be aggregated by centroid cluster analysis revealing valid allergen clusters possibly linked with higher disease severity as determined by multivariate analysis of covariance.
Allergenic molecule microarray analysis can be regarded as a suitable research tool for large-scale IgE screening in infants and children with atopic dermatitis (AD). Still, further studies in well-defined populations are needed to exactly identify its tangible benefits in the diagnostic and therapeutic management of affected patients in daily clinical practice.
患有特应性皮炎的儿童经常表现出过敏原特异性致敏。然而，使用多过敏原微阵列尚未广泛描述相应的 IgE 识别模式。
使用微阵列技术为特应性皮炎患儿提供全面的分子 IgE 库。
用含有一组 95 种吸入性、食物和葡萄球菌抗原成分的蛋白质微阵列筛选 140 例受影响儿童的血清。此外，还记录了总血清 IgE 水平和进一步的临床参数。
在平均总 IgE 水平为 1528 kU/L 的情况下，每位患者的致敏数量从 0 到 32 不等，回归分析显示总 IgE 与识别抗原的数量之间存在显著关联。共有 78 种单一过敏原和微生物成分引起至少一种 IgE 反应，而 11 种植物和 13 种非植物分子被 10%以上的患者识别。14%的儿童可检测到对金黄色葡萄球菌的特异性 IgE。按年龄分层时，对研究过敏原分子的致敏率差异显著。在年龄最小的组（<24 个月）中，对吸入性过敏原和 SEC 的反应性最低，在年龄最大的组（≥72 个月）中达到最高值，而对食物过敏原成分的 IgE 反应在年龄较小的组（0-48 个月）中达到峰值，并在年龄较大的患者中明显下降。大量的微阵列数据可以通过质心聚类分析进行聚合，揭示可能与更高疾病严重程度相关的有效过敏原簇，这是通过协方差多变量分析确定的。
过敏原分子微阵列分析可作为特应性皮炎（AD）婴儿和儿童大规模 IgE 筛选的合适研究工具。然而，仍需要在明确界定的人群中进行进一步的研究，以准确确定其在日常临床实践中对受影响患者的诊断和治疗管理的实际益处。
