Hong Sang Duk, Ryu Gwanghui, Seo Min Young, Jeong Jong In, Kim Hyo Yeol, Chung Seung-Kyu, Dhong Hun-Jong
From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Otorhinolaryngology, Keimyung University College of Medicine, Daegu, South Korea.
Am J Rhinol Allergy. 2018 Jan 25;32(1):23-26. doi: 10.2500/ajra.2018.32.4483.
The most common tests for allergen sensitization in patients with allergic rhinitis are the skin-prick test (SPT) and an in vitro test to detect serum specific immunoglobulin E (sIgE). However, in vitro allergen test results were interpreted dichotomically as positive or negative at a threshold of 0.35 kU/L of sIgE, regardless of the patient characteristics or antigen types.
The purpose of this study was to determine the cutoff value for sIgE in house-dust mites and animal dander, and to analyze differences in cutoff value according to age and gender.
A total of 16,209 patients with more than one allergic rhinitis symptom who underwent both SPT and serum sIgE testing were retrospectively evaluated between March 2008 and May 2012. There were 9374 male (57.8%) and 6835 female (42.2%) patients. The mean age was 31.8 years (range, 2-89 years). The criterion standard for allergen sensitization was defined as a wheal of >3 mm or an allergen-to-histamine ratio of ≥1 in SPT results. The Youden index was used to calculate the cutoff value of sIgE.
Cutoff values of sIgE for Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, and dog were 0.69, 1.16, 0.13, and 0.45 kU/L, respectively. The cutoff value of sIgE changed according to age for D. pteronyssinus and D. farinae but not for cat and dog allergens. When categorizing according to age group, the cutoff values of sIgE for D. pteronyssinus and D. farinae had a tendency to decrease with age. There was no significant difference in cutoff value according to gender.
The cutoff value for sIgE differed for each antigen and changed with age. Physicians should select the proper cutoff value for sIgE for appropriate criteria according to antigen and patient age rather than using a uniform cutoff value.
变应性鼻炎患者中，用于变应原致敏检测最常用的方法是皮肤点刺试验（SPT）和一项用于检测血清特异性免疫球蛋白E（sIgE）的体外试验。然而，体外变应原检测结果在sIgE阈值为0.35 kU/L时被二分法解释为阳性或阴性，而不考虑患者特征或抗原类型。
本研究旨在确定屋尘螨和动物皮屑中sIgE的临界值，并分析根据年龄和性别临界值的差异。
回顾性评估了2008年3月至2012年5月期间共16209例有不止一种变应性鼻炎症状且同时接受了SPT和血清sIgE检测的患者。其中男性9374例（57.8%），女性6835例（42.2%）。平均年龄为31.8岁（范围2至89岁）。变应原致敏的标准定义为SPT结果中风团直径>3 mm或变应原与组胺比值≥1。采用约登指数计算sIgE的临界值。
粉尘螨、屋尘螨、猫和狗的sIgE临界值分别为0.69、1.16、0.13和0.45 kU/L。粉尘螨和屋尘螨的sIgE临界值随年龄变化，而猫和狗变应原的sIgE临界值则不然。按年龄组分类时，粉尘螨和屋尘螨的sIgE临界值有随年龄降低的趋势。根据性别，临界值无显著差异。
sIgE的临界值因抗原而异且随年龄变化。医生应根据抗原和患者年龄选择合适的sIgE临界值以适用恰当的标准，而非使用统一的临界值。
