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[Allerport® HRT在鸡蛋过敏诊断中的应用:一项儿科多中心激发试验研究]

[Utility of the allerport® HRT in the diagnosis of hen's egg allergy: a pediatric multicenter challenge study].

作者信息

Sato Sakura, Ito Komei, Urisu Atsuo, Kando Naoto, Nakagawa Tomoko, Tsuge Ikuya, Kondo Yasuto, Ito Setsuko, Ebisawa Motohiro

机构信息

Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital.

Department of Allergy, Aichi Children's Health and Medical Center.

出版信息

Arerugi. 2015 Feb;64(2):136-48.

Abstract

Purpose This study aimed to evaluate the utility of the Allerport® HRT in the diagnosis of hen's egg allergy. Method We enrolled 51 subjects who underwent the Allerport® HRT before an oral food challenge (OFC) consisting of heated egg. Blood samples were collected within three months prior to OFC to measure histamine release (HR) and specific IgE antibody titers. We examined whether the Allerport® HRT was useful as a means of diagnosing hen's egg allergy and predicting severity of induced symptoms. Of 51 subjects, three whose OFC results were not valid1 and 13 who were classified as "low responders" to the Allerport® HRT (%HR due to anti-IgE below 20%) were excluded. Of the remaining 35 subjects (average age: 4 years), 23 showed positive reactions to the OFC. Quantities of histamine released in spontaneous HR and egg white (EW)- and ovomucoid (OVM)-induced HR were significantly higher in patients with positive reactions. In our receiver operating characteristic analysis, the area under the curve for %HR against 6 ng/ml of EW was 0.9601 and that against 3 ng/ml of OVM was 0.9022. The cutoff value was 15.0% for EW and 3.7% for OVM. The sensitivity was 95.7% for EW and 91.3% for OVM, and the specificity was 83.3% for EW and 58.3% for OVM. %HR correlated well with the severity of induced symptoms in the OFC. Conclusion Allerport® HRT is useful for the diagnosis of hen's egg allergy, and may also aid in predicting the severity of induced symptoms.

摘要

目的 本研究旨在评估Allerport® HRT在鸡蛋过敏诊断中的效用。方法 我们招募了51名在进行含加热鸡蛋的口服食物激发试验(OFC)前接受Allerport® HRT检测的受试者。在OFC前三个月内采集血样,以测量组胺释放(HR)和特异性IgE抗体滴度。我们研究了Allerport® HRT是否可作为诊断鸡蛋过敏及预测诱发症状严重程度的一种手段。51名受试者中,3名OFC结果无效1,13名对Allerport® HRT被归类为“低反应者”(抗IgE导致的%HR低于20%)被排除。在其余35名受试者(平均年龄:4岁)中,23名对OFC呈阳性反应。阳性反应患者的自发HR以及蛋清(EW)和卵类黏蛋白(OVM)诱导的HR中释放的组胺量显著更高。在我们的受试者工作特征分析中,针对6 ng/ml EW的%HR的曲线下面积为0.9601,针对3 ng/ml OVM的为0.9022。EW的临界值为15.0%,OVM的为3.7%。EW的敏感性为95.7%,OVM的为91.3%,EW的特异性为83.3%,OVM的为58.3%。%HR与OFC中诱发症状的严重程度密切相关。结论 Allerport® HRT对鸡蛋过敏的诊断有用,也可能有助于预测诱发症状的严重程度。

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