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[葡萄牙北部儿科人群中对屋尘螨主要变应原1和主要变应原2致敏情况的评估]

[Evaluation of sensitization to Der p 1 and Der p 2 in a pediatric population of the North of Portugal].

作者信息

Peixoto Sara, Soares Joana, Monteiro Tânia, Carvalho Marisa, Santos Marinela, Simões Carla, Quaresma Márcia

机构信息

Departamento de Pediatría, Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Vila Real, Portugal.

Departamento de Pediatría, Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), Vila Real, Portugal.

出版信息

An Pediatr (Engl Ed). 2018 Sep;89(3):162-169. doi: 10.1016/j.anpedi.2017.10.014. Epub 2017 Dec 28.

Abstract

INTRODUCTION

In Portugal, data on the role of Der p 1 and Der p 2 in patients with house dust mite (HDM) allergy are scarce. Allergen-specific immunotherapy (sIT) is the only treatment that improves symptoms, reduces the need for pharmacological therapy and modifies the natural history of the disease. With this study, the authors aim to understand the local epidemiology and to clarify if the molecular assay of major allergens is advantageous in deciding and/or modifying the decision to initiate sIT in children with clinical indication which are sensitized to Dermatophagoides pteronyssinus.

METHODS

Retrospective study with analysis of patients with asthma and/or rhinitis.

STUDY PERIOD

January/2013-December/2016.

INCLUSION CRITERIA

  1. positive prick-test to Dermatophagoides pteronyssinus; and 2) clinically relevant disease under treatment. Assay Der p 1 and Der p 2 values ≥0.35 kUA/L were considered positive. Statistical significance was set at P<.05.

RESULTS

The clinical files of 279 patients. Mean ages 9.55 years (min.4-max.17). Asthma was present in 199 children (71.3%) and rhinitis in 245 (87.8%). Der p 1 and Der p 2 was <0.35kUA/L in 29 (10,4%) patients. The value of Der p 1/Der p 2 correlated with the size of the prick-test papule, the value of the eosinophils and the total IgE.

CONCLUSIONS

Der p 1 and Der p 2 are dominant allergens in our population and there may be benefits in determining these molecular allergen levels in patients with a positive prick-test and a clinical indication for sIT prior to a decision of initiating sIT or not.

摘要

引言

在葡萄牙,关于Der p 1和Der p 2在屋尘螨(HDM)过敏患者中作用的数据稀缺。变应原特异性免疫疗法(sIT)是唯一能改善症状、减少药物治疗需求并改变疾病自然史的治疗方法。通过本研究,作者旨在了解当地的流行病学情况,并阐明主要变应原的分子检测在决定和/或修改对有临床指征且对尘螨过敏的儿童启动sIT的决策方面是否具有优势。

方法

对哮喘和/或鼻炎患者进行回顾性研究分析。

研究期间

2013年1月至2016年12月。

纳入标准

1)对尘螨的点刺试验呈阳性;2)正在接受治疗的临床相关疾病。Der p 1和Der p 2检测值≥0.35 kUA/L被视为阳性。统计学显著性设定为P<0.05。

结果

279例患者的临床资料。平均年龄9.55岁(最小4岁 - 最大17岁)。199名儿童(71.3%)患有哮喘,245名(87.8%)患有鼻炎。29名(10.4%)患者的Der p 1和Der p 2<0.35kUA/L。Der p 1/Der p 2的值与点刺试验丘疹大小、嗜酸性粒细胞值和总IgE相关。

结论

Der p 1和Der p 2是我们研究人群中的主要变应原,在对有阳性点刺试验且有sIT临床指征的患者决定是否启动sIT之前,测定这些分子变应原水平可能有益。

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