Liska Martin, Gutova Vaclava, Panzner Petr, Brodska Petra
Department of Immunology and Allergology, University Hospital Pilsen , Pilsen, Czech Republic .
Department of Dermatovenereology, University Hospital Pilsen , Pilsen, Czech Republic .
Pediatr Allergy Immunol Pulmonol. 2015 Jun 1;28(2):87-91. doi: 10.1089/ped.2014.0434.
Immediate and delayed hypersensitivity reactions can play a role in the pathogenesis of atopic dermatitis (AD). We tested 71 patients (median age 5 years) with AD for hypersensitivity to grass and birch pollen, , and using atopy patch test (APT), skin prick test (SPT), and specific IgE measurement. The sensitivity (SE) and specificity (SP) of the tests were calculated on the basis of personal history of AD exacerbation, clinical AD score (SCORAD) changes, and the number of days with need for topical anti-inflammatory treatment (AITD) in relation to exposure to the allergens being tested. APT was positive in 45 patients, mostly to (=37). SPT and/or specific IgE were positive in 42 subjects, in most cases to grass and birch pollen (=29). SE of APT reached 33%-56% for history, 33% for SCORAD, and 0%-60% for AITD; SP of APT was comparable for all three assessment standards (history, SCORAD, and AITD) (48%-67%). SE of SPT/specific IgE was higher for history (26%-63%) than for the other two standards of assessment (0%-67%); SP of SPT/specific IgE was also highest for history (69%-91%), and lower for SCORAD (59%-87%) and AITD (65%-80%). AD is often associated with hypersensitivity; its influence on AD, however, is clinically significant only in a minor group of patients. While personal history and SCORAD changes present themselves as possible standards in the evaluation of clinically relevant hypersensitivity in AD patients, the anti-inflammatory treatment days (AITD) appears to be unsuitable for this purpose.
速发型和迟发型超敏反应可能在特应性皮炎（AD）的发病机制中起作用。我们对71例AD患者（中位年龄5岁）进行了针对草花粉和桦树花粉的超敏反应检测，采用特应性斑贴试验（APT）、皮肤点刺试验（SPT）和特异性IgE检测。根据AD病情加重的个人史、临床AD评分（SCORAD）变化以及与接触所检测过敏原相关的局部抗炎治疗（AITD）天数，计算这些检测的敏感性（SE）和特异性（SP）。45例患者的APT呈阳性，大多针对 （=37）。42例受试者的SPT和/或特异性IgE呈阳性，在大多数情况下针对草花粉和桦树花粉（=29）。APT对于病情加重史的SE达到33%-56%，对于SCORAD为33%，对于AITD为0%-60%；APT对于所有三项评估标准（病情加重史、SCORAD和AITD）的SP相当（48%-67%）。SPT/特异性IgE对于病情加重史的SE（26%-63%）高于其他两项评估标准（0%-67%）；SPT/特异性IgE对于病情加重史的SP也最高（69%-91%），对于SCORAD较低（5%-87%），对于AITD为（65%-80%）。AD常与超敏反应相关；然而，其对AD的影响仅在一小部分患者中具有临床意义。虽然个人史和SCORAD变化可作为评估AD患者临床相关超敏反应的可能标准，但抗炎治疗天数（AITD）似乎不适用于此目的。
