过敏医学中的争论：未来，使用ISAC进行的分子过敏诊断将取代皮肤点刺试验筛查。
Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future.
作者信息
Jensen-Jarolim E, Jensen A N, Canonica G W
机构信息
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
The interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University of Vienna, Vienna, Austria.
出版信息
World Allergy Organ J. 2017 Sep 19;10(1):33. doi: 10.1186/s40413-017-0162-3. eCollection 2017.
In today's clinical practice patients' skin is used as screening organ for diagnosing type 1 allergy. According to European guidelines skin prick testing with a panel of 18 allergen extracts is recommended, in the US between 10 to 50 allergens are used. The specificity and sensitivity of skin testing is individually highly variable depending on age, body mass, and skin barrier status. In atopic inflammation skin testing gives more false positive results. Smaller skin area and strain limits prick testing in small children. Although the risk for systemic reactions in skin prick testing is very small, emergency medications must be available. Considering the fact that IgE is the only reliable biomarker for type I allergy, upfront IgE screening with ISAC, followed by fewer skin tests to approve positive sensitizations, is proposed. It is time to arrive in the age of molecular allergy diagnosis in daily patient care.
在当今的临床实践中，患者的皮肤被用作诊断1型过敏的筛查器官。根据欧洲指南，建议使用一组18种变应原提取物进行皮肤点刺试验，在美国则使用10至50种变应原。皮肤试验的特异性和敏感性因年龄、体重和皮肤屏障状态而异，个体差异很大。在特应性炎症中，皮肤试验会产生更多假阳性结果。较小的皮肤面积和张力限制了对幼儿进行点刺试验。尽管皮肤点刺试验发生全身反应的风险非常小，但必须备有急救药物。鉴于IgE是1型过敏唯一可靠的生物标志物，建议先用ISAC进行IgE筛查，然后进行较少的皮肤试验以确认阳性致敏。日常患者护理中分子过敏诊断的时代已经到来。
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