Department of Otorhinolaryngology-Head and Neck Surgery, Ludwig-Maximilian-University Munich, Marchioninistrasse 15, 81377, Munich, Germany,
Eur Arch Otorhinolaryngol. 2013 Nov;270(12):3177-82. doi: 10.1007/s00405-013-2516-y. Epub 2013 Apr 30.
Recombinant allergen diagnostics have become increasingly important in daily allergological routine, made possible by inroads into the understanding of major and minor allergens accomplished within the last decade. Recombinant allergen diagnostics will, however, only provide correct diagnoses when sufficient knowledge of the regional IgE reactivity profile to a specific allergen source is available. A variety of studies in different European countries revealed reactivity profiles, where a sensitization to house dust mite could be recognized in more than 97 % of cases in which Der p1 and Der p2 were measured. The aim of this study was to investigate the IgE reactivity profiles of house dust mite allergic patients in southern Germany. Sera of house dust mite allergic patients (positive intranasal provocation) were screened for IgE antibodies against commercially available D pter., nDer p1, rDer p2 and rDer p10. IgE antibodies against D pter. could be found in 98 out of 98 sera (100 %). Seventy-five patients (76.5 %) reacted to nDer p1. In 72 patients (73.4 %), IgE antibodies against rDer p2 could be found, while IgE antibodies against rDer p10 were present in only 4 patients (4.1 %). Seventeen patients (17.3 %) had no IgE antibodies against nDer p1, rDer p2 and nDer p10, but displayed reactions to D pter. Knowledge of IgE regional reactivity profiles is necessary when using recombinant allergen diagnostics. In the case of our house dust mite allergic patients 17 would have remained undiagnosed based on a diagnostic method utilizing only the two major allergens nDerp1 and rDerp2.
重组过敏原诊断在日常过敏学常规中变得越来越重要，这得益于过去十年对主要和次要过敏原的深入了解。然而，只有在对特定过敏原来源的区域 IgE 反应性有足够了解的情况下，重组过敏原诊断才能提供正确的诊断。在不同的欧洲国家进行的各种研究揭示了反应性图谱，在这些图谱中，对屋尘螨的致敏性可以在超过 97%的情况下被识别，这些情况下测量了 Der p1 和 Der p2。本研究的目的是调查德国南部的屋尘螨过敏患者的 IgE 反应性图谱。屋尘螨过敏患者（经鼻内激发阳性）的血清被筛选出针对商业上可获得的 D pter.、nDer p1、rDer p2 和 rDer p10 的 IgE 抗体。在 98 份血清中（100%）发现了针对 D pter.的 IgE 抗体。75 名患者（76.5%）对 nDer p1 有反应。在 72 名患者（73.4%）中发现了针对 rDer p2 的 IgE 抗体，而针对 rDer p10 的 IgE 抗体仅在 4 名患者（4.1%）中存在。17 名患者（17.3%）对 nDer p1、rDer p2 和 nDer p10 没有 IgE 抗体，但对 D pter.有反应。当使用重组过敏原诊断时，了解 IgE 区域反应性图谱是必要的。在我们的屋尘螨过敏患者中，有 17 名患者如果仅使用 nDerp1 和 rDerp2 这两种主要过敏原进行诊断，就会被漏诊。
