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分子过敏诊断在哮喘临床特征中的应用。

Molecular allergy diagnosis for the clinical characterization of asthma.

机构信息

Allergy Department, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES, Institute Carlos III, Ministry of Economy and Competitiveness) Madrid, Universidad Autónoma de Madrid, Madrid, Spain.

出版信息

Expert Rev Mol Diagn. 2015 Jun;15(6):789-99. doi: 10.1586/14737159.2015.1036745. Epub 2015 Apr 12.

Abstract

Defining the allergen sensitization of a patient with asthma at the molecular level by measuring specific IgE to purified natural or recombinant allergens can improve diagnostic accuracy and improve asthma phenotyping. Molecular diagnosis is possible thanks to the specificity of some markers of species-specific sensitization and resolve cross-reactivity phenomena from a true co-sensitization. None of this precision is possible with conventional allergy tests, and such information will eventually give clinicians the possibility to individualize the actions taken, including indications on reducing targeted-allergen exposure or selection of suitable allergens for specific immunotherapy, thereby increasing the safety and efficacy of immunotherapy. Nevertheless, all in vitro tests should be assessed alongside clinical history, as allergen sensitization does not necessarily imply clinical responsiveness.

摘要

通过测量对纯化天然或重组过敏原的特异性 IgE,在分子水平上定义哮喘患者的过敏原致敏,可以提高诊断准确性并改善哮喘表型。分子诊断成为可能,这要归功于一些物种特异性致敏标志物的特异性,并解决了真正共致敏的交叉反应现象。常规过敏测试不可能具有这种精度,而这些信息最终将使临床医生有可能对所采取的行动进行个体化,包括减少针对过敏原暴露的指示或选择合适的过敏原进行特异性免疫治疗,从而提高免疫治疗的安全性和有效性。然而,所有体外测试都应与临床病史一起评估,因为过敏原致敏并不一定意味着临床反应性。

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