Cichocka-Jarosz Ewa, Sanak Marek, Szczeklik Andrzej, Brzyski Piotr, Pietrzyk Jacek J
Chair of Pediatrics, Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland.
Chair of Medicine, Department of Medicine, Jagiellonian University Medical College, Cracow, Poland.
Ann Agric Environ Med. 2014;21(2):294-301. doi: 10.5604/1232-1966.1108594.
Mast cells (MC) are effector cells during severe systemic reactions (SR) to Hymenoptera stings. Venom specific immunotherapy (VIT) is the treatment of choice for prevention of SR to stings. Tryptase and prostaglandin D₂ metabolites (PGD₂) are the markers of MC activation. The study design was to 1. compare baseline values of serum tryptase concentration (BST) and PGD₂ metabolites in children with/without venom sensitization, 2. to evaluate an influence of rush VIT on MC markers in treated children.
Sensitized group: 25 children with SR to Hymenoptera sting.
19 healthy children. Active treatment: 5-day-rush-VIT. BST was evaluated by ImmunoCAP, PGD₂ metabolites in blood and urine by GC-NICI-MS.
The baseline blood levels of MC markers were significantly higher, while urinary concentration of 9α,11β-PGF₂ was significantly lower in the whole group of venom-sensitized children compared to controls. Severity of SR showed negative correlation with urinary PGD₂ metabolites, while positive with plasma 9α,11β-PGF₂ and BST concentration The highest sensitivity was obtained for plasma 9α,11β-PGF₂ whereas the highest specificity for urinary PGD-M.
In children with IgE-mediated SR to Hymenoptera stings, elevation of baseline values of PGD₂ metabolites in blood is accompanied by decreased excretion of its urinary metabolites. Assessment of stable PGD₂ metabolites might serve as an independent MC marker to identify allergic children. There is an association between urinary PGD₂ metabolites and severity of the SR to Hymenoptera stings.
肥大细胞（MC）是对膜翅目昆虫叮咬发生严重全身反应（SR）时的效应细胞。毒液特异性免疫疗法（VIT）是预防叮咬引起SR的首选治疗方法。类胰蛋白酶和前列腺素D₂代谢物（PGD₂）是MC活化的标志物。本研究旨在：1. 比较有/无毒液致敏儿童血清类胰蛋白酶浓度（BST）和PGD₂代谢物的基线值；2. 评估快速VIT对接受治疗儿童MC标志物的影响。
致敏组：25名对膜翅目昆虫叮咬发生SR的儿童。
19名健康儿童。积极治疗：5天快速VIT。通过免疫化学发光法评估BST，通过气相色谱-负离子化学电离质谱法评估血液和尿液中的PGD₂代谢物。
与对照组相比，毒液致敏儿童全组的MC标志物基线血水平显著更高，而尿中9α,11β-前列腺素F₂的浓度显著更低。SR的严重程度与尿中PGD₂代谢物呈负相关，与血浆9α,11β-前列腺素F₂和BST浓度呈正相关。血浆9α,11β-前列腺素F₂的敏感性最高，而尿中PGD-M的特异性最高。
在对膜翅目昆虫叮咬发生IgE介导SR的儿童中，血液中PGD₂代谢物基线值升高伴随着其尿代谢物排泄减少。评估稳定的PGD₂代谢物可能作为识别过敏儿童的独立MC标志物。尿中PGD₂代谢物与膜翅目昆虫叮咬引起的SR严重程度之间存在关联。
