J Investig Allergol Clin Immunol. 2014;24(1):29-34.
It is still uncertain whether house dust mite (HDM) tropomyosin present in allergen extracts can cross-sensitize patients receiving subcutaneous immunotherapy (SCIT) and thus induce food allergy.
Our aim was to assess whether new sensitization to tropomyosin occurred during HDM-SCIT, and, if so, whether it was clinically relevant.
The study sample comprised 56 HDM-allergic patients treated with SCIT using HDM extract. All patients were screened for specific IgE (sIgE) to mite tropomyosin (rDer p 10) before and after SCIT. In patients with a positive result, we also monitored the dynamics of sIgE to rDer p 10 and shrimp tropomyosin (rPen a 1) at several time points. The levels of sIgE were measured using the CAP System fluorescent-enzyme immunoassay.
sIgE to tropomyosin was found in only 5 patients, 3 of whom expressed low and clinically irrelevant levels of sIgE to Der p 10, while sIgE to Pen a 1 was not found. The remaining 2 patients expressed sIgE to both tropomyosins. In the first, the initial increase and subsequent decrease resembled the dynamics of the IgE antibodies usually seen in SCIT patients and were never accompanied by seafood-induced symptoms. In the other, a decrease in levels of sIgE to both tropomyosins resulted in the complete loss of his reactivity toward seafood.
Immunotherapy using HDM extracts does not induce clinically relevant sensitization to tropomyosin. In certain cases of combined mite and seafood allergy, treatment may even lead to the improvement of food allergy symptoms. The levels of sIgE to Der p 10 and Pen a 1 may be useful monitoring markers.
目前仍不确定过敏原提取物中的屋尘螨（HDM）肌球蛋白是否会使接受皮下免疫治疗（SCIT）的患者发生交叉致敏，从而引发食物过敏。
本研究旨在评估 HDM-SCIT 过程中是否会发生新的肌球蛋白致敏，如果发生，是否具有临床相关性。
研究样本包括 56 例接受 HDM 提取物 SCIT 的 HDM 过敏患者。所有患者在 SCIT 前后均进行了针对螨肌球蛋白（rDer p 10）的特异性 IgE（sIgE）检测。对于阳性结果的患者，我们还在多个时间点监测了 rDer p 10 和虾肌球蛋白（rPen a 1）的 sIgE 动态变化。sIgE 水平采用 CAP 系统荧光酶免疫分析法进行测量。
仅在 5 例患者中发现了肌球蛋白 sIgE，其中 3 例患者对 Der p 10 的 sIgE 水平较低且无临床意义，而未发现对 Pen a 1 的 sIgE。其余 2 例患者同时对两种肌球蛋白均表达 sIgE。在第一个病例中，初始增加和随后的减少类似于 SCIT 患者中通常观察到的 IgE 抗体动态变化，且从未伴有海鲜诱发的症状。在另一个病例中，两种肌球蛋白的 sIgE 水平下降导致其对海鲜的反应完全丧失。
使用 HDM 提取物的免疫治疗不会引起临床相关的肌球蛋白致敏。在某些尘螨和海鲜过敏同时存在的情况下，治疗甚至可能导致食物过敏症状的改善。Der p 10 和 Pen a 1 的 sIgE 水平可能是有用的监测标志物。
