Darsow U, Brockow K, Pfab F, Jakob T, Petersson C J, Borres M P, Ring J, Behrendt H, Huss-Marp J
Department of Dermatology and Allergy, Technische Universität München, Munich, Germany; ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany.
Clin Exp Allergy. 2014;44(5):778-86. doi: 10.1111/cea.12303.
Data on molecular allergy diagnostics in adults with grass pollen allergy with regard to conjunctival and nasal provocation test outcome and specific immunotherapy are lacking to date.
To assess whether molecular allergy diagnostics for grass pollen allergens could help with predicting provocation test outcomes and serve as a basis for future component-resolved specific immunotherapy.
Sera of 101 adults with grass pollen allergy was analysed for IgE against timothy grass pollen (Phleum pratense), rPhl p 1, rPhl p 2, nPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11 and rPhl p12 and correlated with the individuals' outcome in the nasal and conjunctival provocation tests and investigated in regard to a potential component-resolved specific immunotherapy.
An increasing number of sensitizations to timothy grass allergens was correlated to a positive reaction in the conjunctival (4.9 vs. 3.6, P = 0.003) and nasal provocation tests (4.5 vs. 2.2, P = 0.0175). In molecular sensitization profiles, a substantial heterogeneity was detected, with none of the patients exactly matching the allergen composition of a previously published component-resolved specific immunotherapy containing Phl p 1, Phl p 2, Phl p 5a/b and Phl p 6. The results indicate that in 95% of the patients, a proportion of 50% of timothy-IgE would be targeted with such a specific immunotherapy, while in 50% and 10% of patients, 80% and 90% of timothy-IgE would be targeted, respectively.
Molecular allergy diagnostics is a prerequisite for future component-resolved specific immunotherapy due to the high heterogeneity of sensitization profiles. However, of current clinical relevance is the observed correlation between the number of sensitizations and provocation test outcome.
迄今为止，缺乏关于草花粉过敏成人分子过敏诊断与结膜和鼻腔激发试验结果及特异性免疫治疗方面的数据。
评估草花粉过敏原的分子过敏诊断是否有助于预测激发试验结果，并为未来的组分解析特异性免疫治疗提供依据。
分析了101例草花粉过敏成人血清中针对梯牧草花粉（早熟禾）、rPhl p 1、rPhl p 2、nPhl p 4、rPhl p 5b、rPhl p 6、rPhl p 7、rPhl p 11和rPhl p12的IgE，并将其与个体在鼻腔和结膜激发试验中的结果相关联，同时就潜在的组分解析特异性免疫治疗进行研究。
对梯牧草过敏原致敏数量的增加与结膜激发试验阳性反应（4.9对3.6，P = 0.003）和鼻腔激发试验阳性反应（4.5对2.2，P = 0.0175）相关。在分子致敏谱中，检测到显著的异质性，没有患者与先前发表的包含Phl p 1、Phl p 2、Phl p 5a/b和Phl p 6的组分解析特异性免疫治疗的过敏原组成完全匹配。结果表明，在95%的患者中，这样的特异性免疫治疗可靶向50%的梯牧草IgE，而在50%和10%的患者中，分别可靶向80%和90%的梯牧草IgE。
由于致敏谱的高度异质性，分子过敏诊断是未来组分解析特异性免疫治疗的先决条件。然而，目前临床相关的是观察到的致敏数量与激发试验结果之间的相关性。
