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[在通过MAST-26检测未发现IgE反应的哮喘患者中与变应原特异性IgE反应存在相关的因素]

[FACTORS ASSOCIATED WITH THE PRESENCE OF ALLERGEN-SPECIFIC IgE RESPONSES IN ASTHMA PATIENTS WHO HAD NO IgE RESPONSES DETECTABLE BY MAST-26].

作者信息

Iijima Hiroaki, Kaneko Yoshiko, Masuko Hironori, Yamada Hideyasu, Yatagai Yohei, Sakamoto Tohru, Kanemoto Koji, Ishikawa Hiroichi, Saito Takefumi, Endo Takeo, Ninomiya Hiroki, Nomura Akihiro, Kodama Takahide, Kaneko Norihiro, Kokubu Fumio, Makita Hironi, Konno Satoshi, Nishimura Masaharu, Hizawa Nobuyuki

机构信息

Department of Respiratory Medicine, Tsukuba Medical Center Hospital.

出版信息

Arerugi. 2015 Sep;64(9):1242-53. doi: 10.15036/arerugi.64.1242.

Abstract

AIM

To elucidate the characteristics of patients with asthma who have specific IgE responses to inhaled allergens detected by ImmunoCAP, which is not detectable by MAST-26.

METHODS

A total of 168 patients with adult asthma who reside in the Kanto region were recruited. Levels of total serum IgE and allergen specific IgE antibodies towards 14 common inhaled allergens (MAST-26) were measured. Among these samples, 48 patients with no detectable allergen-specific IgE (group A) and 44 patients with strong sensitization to Dermatophagoides farinae (group B) were selected for further assessment of their sensitization to inhaled allergens such as cockroach and moth using ImmunoCAP.

RESULTS

In group A, ImmunoCAP detected specific IgE responses to some inhaled allergens in 27.1% of the patients. The strongest predictive factor for the presence of allergen-specific IgE responses detected by ImmunoCAP was elevated levels of total serum IgE (p=0.0007). In group B, the presence of IgE responses specific to cockroach or moth by ImmunoCAP were found in 27.8% or 52.3% of the patients, respectively. The predictive factor for the presence of these positive IgE responses was also elevated levels of total serum IgE (p=0.0003).

CONCLUSION

Asthma patients with no detectable specific IgE responses to any inhaled allergens by MAST-26 may be still sensitized to common inhaled allergens, including cockroach and moth. Thus, the presence of allergen-specific IgE responses may be re-assessed by ImmunoCAP in patients with asthma, especially when patients have higher levels of total serum IgE.

摘要

目的

阐明对吸入性变应原具有特异性IgE反应的哮喘患者的特征,这些反应可通过免疫捕获法(ImmunoCAP)检测到,但无法通过MAST-26检测到。

方法

招募了168名居住在关东地区的成年哮喘患者。测量了血清总IgE水平以及针对14种常见吸入性变应原(MAST-26)的变应原特异性IgE抗体水平。在这些样本中,选择了48名未检测到变应原特异性IgE的患者(A组)和44名对粉尘螨有强烈致敏反应的患者(B组),以使用免疫捕获法进一步评估他们对蟑螂和飞蛾等吸入性变应原的致敏情况。

结果

在A组中,免疫捕获法在27.1%的患者中检测到对某些吸入性变应原的特异性IgE反应。免疫捕获法检测到变应原特异性IgE反应存在的最强预测因素是血清总IgE水平升高(p=0.0007)。在B组中,免疫捕获法分别在27.8%或52.3%的患者中发现了对蟑螂或飞蛾的特异性IgE反应。这些阳性IgE反应存在的预测因素也是血清总IgE水平升高(p=0.0003)。

结论

通过MAST-26未检测到对任何吸入性变应原具有特异性IgE反应的哮喘患者,可能仍对包括蟑螂和飞蛾在内的常见吸入性变应原致敏。因此,对于哮喘患者,尤其是血清总IgE水平较高的患者,可通过免疫捕获法重新评估变应原特异性IgE反应的存在情况。

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