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尘螨、粉螨和热带无爪螨致敏在间歇性和持续性过敏性哮喘中诱导产生的血清特异性IgE定量水平差异

The Differences in Serum Quantitative Specific IgE Levels Induced by Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis Sensitization in Intermittent and Persistent Allergic Asthma.

作者信息

Susanto Agus Joko, Rengganis Iris, Rumende Cleopas M, Harimurti Kuntjoro

机构信息

Department of Internal Medicine, Faculty of Medicine, University of Sebelas Maret - dr. Moewardi Hospital, Surakarta, Indonesia.

出版信息

Acta Med Indones. 2017 Oct;49(4):299-306.

Abstract

BACKGROUND

house dust mites (HDM) are an important inhalant allergen in allergic asthma. However, molecular diagnostic study of specific IgE to HDM allergens has not been done in Indonesia. In addition, the association of quantitative specific IgE measurement with asthma severity has not been investigatedd. This study aimed to investigate the difference of serum quantitative specific IgE levels induced by Dermatophagoides (D.) pteronyssinus, D. farinae and Blomia tropicalis sensitization in intermittent and persistent allergic asthma.

METHODS

this was a cross-sectional study on adult allergic asthma patients who were invited for serum specific IgE testing. This study was a part of a larger study within the Division of Allergy and Immunology, Cipto Mangunkusumo Hospital. Asthma severity was defined based on Global Initiative on Asthma (GINA) 2015 criteria and were grouped as intermittent or persistent. Quantitative specific IgE testing was done on blood serum using a multiple allergosorbent test (Polycheck Allergy, Biocheck GmbH, Munster, Germany). The HDM allergens tested were D. pteronyssinus, D. farinae, and Blomia tropicalis. Difference between two groups were analyze using Mann-Whitney test.

RESULTS

a total of 87 subjects were enrolled in this study; 69 (79.3%) were women. Mean patients' age was 40, 2 years. Sixty-three (72.4%) subjects had asthma and allergic rhinitis. Fifty-eight (66.7%) subjects were classified as persistent asthma. The prevalence of sensitization was 62.1% for D. farinae, 51.7% for D. pteronyssinus, and 48.3% for Blomia tropicalis. The median of specific IgE levels were significantly higher in persistent asthma compares to intermittent asthma induced by D. farinae (median 1.30 vs. 0.0 kU/L; p=0.024) and B. tropicalis (median 0.57 vs. 0.0 kU/L; p=0.015) sensitization. Level of Specific IgE  D. pteronyssinus was also to be higher in persistent asthma than the level measured in intermittent asthma (0.67 vs. 0.00 kU/L; p=0.066).

CONCLUSION

Sensitization of HDM allergens was shown to be highest for D. farinae 62.1%, followed by D. pteronyssinus 51.7% and Blomia tropicalis 48.3%. Specific IgE level induced by D. farinae and Blomia tropicalis sensitization were significantly higher in patients with persistent asthma compared to intermittent asthma, whereas specific IgE level induced by D. pteronyssinus sensitization was higher in persistent asthma although not statistically significant.

摘要

背景

屋尘螨(HDM)是过敏性哮喘中一种重要的吸入性变应原。然而,印度尼西亚尚未开展针对HDM变应原特异性IgE的分子诊断研究。此外,定量特异性IgE测量与哮喘严重程度之间的关联也未得到研究。本研究旨在调查在间歇性和持续性过敏性哮喘中,由粉尘螨、户尘螨和热带无爪螨致敏引起的血清定量特异性IgE水平的差异。

方法

这是一项对成年过敏性哮喘患者进行血清特异性IgE检测的横断面研究。本研究是Cipto Mangunkusumo医院过敏与免疫学部门一项更大研究的一部分。哮喘严重程度根据2015年全球哮喘防治创议(GINA)标准定义,并分为间歇性或持续性。使用多过敏原吸附试验(Polycheck Allergy,Biocheck GmbH,明斯特,德国)对血清进行定量特异性IgE检测。检测的HDM变应原包括粉尘螨、户尘螨和热带无爪螨。两组之间的差异采用Mann-Whitney检验进行分析。

结果

本研究共纳入87名受试者;69名(79.3%)为女性。患者平均年龄为40.2岁。63名(72.4%)受试者患有哮喘和过敏性鼻炎。58名(66.7%)受试者被分类为持续性哮喘。粉尘螨致敏率为62.1%,户尘螨为51.7%,热带无爪螨为48.3%。与粉尘螨致敏(中位数1.30 vs. 0.0 kU/L;p=0.024)和热带无爪螨致敏(中位数0.57 vs. 0.0 kU/L;p=0.015)引起的间歇性哮喘相比,持续性哮喘中特异性IgE水平的中位数显著更高。持续性哮喘中户尘螨特异性IgE水平也高于间歇性哮喘中测得的水平(0.67 vs. 0.00 kU/L;p=0.066)。

结论

HDM变应原致敏率最高的是粉尘螨,为62.1%,其次是户尘螨,为51.7%,热带无爪螨为48.3%。与间歇性哮喘相比,持续性哮喘患者中由粉尘螨和热带无爪螨致敏引起的特异性IgE水平显著更高,而由户尘螨致敏引起的特异性IgE水平在持续性哮喘中更高,尽管无统计学意义。

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