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[嗜碱性粒细胞活化试验——常见呼吸道过敏诊断的实用方法]

[Basophil activation test--a practical approach to diagnosis of common respiratory allergy].

作者信息

Leśniak Małgorzata, Dyga Wojciech, Porębski Grzegorz, Czarnobilska Ewa

出版信息

Przegl Lek. 2015;72(12):725-30.

Abstract

BACKGROUND

The diagnosis of immediate allergy is based on clinical data, skin prick tests (SPT), and measurements of allergen-specific IgE (sIgE). Basophil activation test (BAT) can supplement these methods and obviate their disadvantages, and possibly replace allergen challenge tests, such as a nasal provocative test (NPT). In this study, we assessed the influence of different storage times on BAT results. Futhermore, we compared the results of SPT, sIgE and NPT against BAT for common aeroallergens.

METHODS

BAT was performed in twelve patients with allergic rhinitis sensitized to birch pollen or mites 1, 4 and 24 hours after blood sampling. CD63 was used as an activation marker. Three serial 10-fold dilutions (1:1, 1:10, 100) of allergen extract were employed. The further 10 individuals allergic to mites undergone complete diagnostic evaluation including SPT, sIgE measurements, NPT and BAT. Receiver operating characteristic (ROC) curves were used to compare the diagnostic techniques and tests conditions.

RESULTS

Basophil activation expressed as stimulation index did not decline significantly up to 24h. Exposure to causal allergens resulted in a dose-dependent increase in expression of CD63 on peripheral blood basophils in tested individuals. We did not observed substantial differences in results of the investigated diagnostic methods determined by a ROC analysis.

CONCLUSIONS

Flow-assisted diagnosis of common respiratory allergy relies upon allergen-induced activation of blood basophils can be a useful approach to determine the clinically relevant allergen in sensitized individuals. BAT with inhaled allergens can be performed within 24 hours after blood collecting into a tube with EDTA. Allergen suitable for NPT in appropriate dilutions is a good reagent for use in BAT.

摘要

背景

速发型过敏的诊断基于临床数据、皮肤点刺试验(SPT)以及过敏原特异性IgE(sIgE)检测。嗜碱性粒细胞活化试验(BAT)可补充这些方法并避免其缺点,甚至可能取代过敏原激发试验,如鼻激发试验(NPT)。在本研究中,我们评估了不同储存时间对BAT结果的影响。此外,我们比较了常见气传过敏原的SPT、sIgE和NPT与BAT的结果。

方法

对12例对桦树花粉或螨过敏的变应性鼻炎患者在采血后1小时、4小时和24小时进行BAT。使用CD63作为活化标志物。采用过敏原提取物的三个连续10倍稀释度(1:1、1:10、1:100)。另外10例对螨过敏的个体接受了包括SPT、sIgE检测、NPT和BAT在内的完整诊断评估。采用受试者操作特征(ROC)曲线比较诊断技术和检测条件。

结果

以刺激指数表示的嗜碱性粒细胞活化在24小时内未显著下降。接触相关过敏原导致受试个体外周血嗜碱性粒细胞上CD63表达呈剂量依赖性增加。通过ROC分析确定的所研究诊断方法的结果未观察到实质性差异。

结论

基于过敏原诱导的血液嗜碱性粒细胞活化的流式辅助诊断常见呼吸道过敏,可能是确定致敏个体中临床相关过敏原的有用方法。使用吸入性过敏原的BAT可在血液采集到含有EDTA的试管中后24小时内进行。适合NPT的适当稀释度的过敏原是BAT的良好试剂。

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