Przybilla B, Ring J, Wielgosch J
Dermatologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Hautarzt. 1988 Oct;39(10):662-70.
In 181 patients with systemic reactions to hymenoptera stings as a result of immediate-type allergy to bee or wasp venom confirmed by history, skin testing and demonstration of hymenoptera venom-specific IgE antibodies on radioallergosorbent testing (RAST), in vitro histamine release from peripheral basophilic granulocytes following stimulation with bee or wasp venom was evaluated. Suspensions of washed peripheral leukocytes at a density of 2 x 10(6)/ml were incubated with four different concentrations of hymenoptera venoms. Histamine was measured by spectrofluorometry, and histamine release was calculated as a percentage of the total histamine content. Tests performed with peripheral leukocytes obtained from 18 non-allergic individuals served as controls. In both bee venom allergy and wasp venom allergy the corresponding allergen induced concentration-dependent histamine release. Upper normal limits of histamine release were defined for the venom concentrations used. When these were used as reference values the basophil histamine release test exhibited a specificity of 94% and a sensitivity of 82% in the diagnosis of bee venom allergy, and a specificity of 83% and a sensitivity of 68% in the diagnosis of wasp venom allergy. Since there was no relevant significant correlation between the results of the basophil histamine release test on one hand and the severity of sting reactions and the prick test and RAST results on the other, it seems that the histamine release test determined additional parameters of sensitization. Thus, the method is a valuable adjunct to the in vitro methods available for the diagnosis of hymenoptera venom allergy.
对181例因蜜蜂或黄蜂毒液速发型过敏而出现全身反应的患者进行了研究,这些患者通过病史、皮肤试验以及放射变应原吸附试验(RAST)证实了对膜翅目昆虫毒液存在特异性IgE抗体。对这些患者进行了评估,观察其外周嗜碱性粒细胞在受到蜜蜂或黄蜂毒液刺激后体外组胺释放情况。将密度为2×10⁶/ml的洗涤后外周白细胞悬液与四种不同浓度的膜翅目昆虫毒液一起孵育。通过荧光分光光度法测量组胺,并将组胺释放量计算为总组胺含量的百分比。从18名非过敏个体获取的外周白细胞进行的试验用作对照。在蜜蜂毒液过敏和黄蜂毒液过敏中,相应的变应原均诱导了浓度依赖性组胺释放。针对所使用的毒液浓度确定了组胺释放的正常上限。当将这些上限用作参考值时,嗜碱性粒细胞组胺释放试验在诊断蜜蜂毒液过敏时特异性为94%,敏感性为82%;在诊断黄蜂毒液过敏时特异性为83%,敏感性为68%。由于一方面嗜碱性粒细胞组胺释放试验结果与蜇伤反应的严重程度以及点刺试验和RAST结果之间没有显著相关性,因此组胺释放试验似乎确定了致敏的其他参数。因此,该方法是可用于诊断膜翅目昆虫毒液过敏的现有体外方法的有价值辅助手段。