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鼻分泌物中特异性免疫球蛋白E用于变应性鼻炎的诊断

The use of specific immunoglobulin E in nasal secretions for the diagnosis of allergic rhinitis.

作者信息

Meng Yifan, Lou Hongfei, Wang Yang, Wang Chengshuo, Zhang Luo

机构信息

Department of Otolaryngology Head and Neck Surgery, Beijing, People's Republic of China.

Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, People's Republic of China.

出版信息

Laryngoscope. 2018 Sep;128(9):E311-E315. doi: 10.1002/lary.27120. Epub 2018 Feb 8.

Abstract

OBJECTIVE

Although local specific immunoglobulin (sIgE) has been employed as a diagnostic criterion for allergic rhinitis (AR), the use of local sIgE has not been fully evaluated in the diagnosis of allergic rhinitis. The aim of this study was to evaluate the use of nasal secretion sIgE in the diagnosis of allergic rhinitis.

METHODS

A total of 51 patients (27 males and 24 females, mean age = 33.3 years) with rhinitis symptoms were enrolled consecutively from the allergy-rhinology clinic of Beijing TongRen Hospital (Beijing, People's Republic of China). Questionnaires were completed by each participant at recruitment to record demographic data, nasal symptom severity, and physician-diagnosed comorbid asthma. The severity of nasal obstruction, rhinorrhea, sneezing, and nasal/eye itching was recorded according to a visual analogue scale (VAS) of 10 cm. Sensitization to Dermatophagoides pteronyssinus, Dermatophagoides farinae, mugwort, Candida albicans, Penicillium notatum, Alternaria, Cladosporium, and Aspergillus were assessed according to presence of sIgE antibodies to these allergens in serum and nasal secretions.

RESULTS

VAS scores of the participants ranged from 11 to 25 (mean = 17), and 14 (27.5%) patients had comorbid asthma. Based on serum sIgE, 31 (60.8%) patients were allergic to mugwort, 14 (27.5%) to Dermatophagoides, and three (5.9%) to fungal allergens. Based on nasal secretion sIgE, 32 (62.7%) patients were allergic to mugwort, 12 (23.5%) to Dermatophagoides, and three (5.9%) to fungal allergens. The local mugwort sIgE level and serum mugwort sIgE level were positively correlated with each other and with VAS scores.

CONCLUSION

sIgE level in nasal secretions of subjects with rhinitis is a reliable noninvasive alternative to serum sIgE for diagnosis of allergic rhinitis.

LEVEL OF EVIDENCE

  1. Laryngoscope, 128:E311-E315, 2018.
摘要

目的

尽管局部特异性免疫球蛋白(sIgE)已被用作变应性鼻炎(AR)的诊断标准,但局部sIgE在变应性鼻炎诊断中的应用尚未得到充分评估。本研究的目的是评估鼻分泌物sIgE在变应性鼻炎诊断中的应用。

方法

连续纳入北京同仁医院(中华人民共和国北京)变态反应鼻科门诊有鼻炎症状的51例患者(男27例,女24例,平均年龄33.3岁)。每位参与者在入组时填写问卷,记录人口统计学数据、鼻部症状严重程度以及医生诊断的合并哮喘情况。根据10厘米的视觉模拟量表(VAS)记录鼻塞、流涕、打喷嚏以及鼻/眼瘙痒的严重程度。根据血清和鼻分泌物中针对这些过敏原的sIgE抗体的存在情况,评估对尘螨、粉螨、艾蒿、白色念珠菌、青霉、链格孢属、枝孢属和曲霉属的致敏情况。

结果

参与者的VAS评分范围为11至25(平均 = 17),14例(27.5%)患者合并哮喘。基于血清sIgE,31例(60.8%)患者对艾蒿过敏,14例(27.5%)对螨类过敏,3例(5.9%)对真菌过敏原过敏。基于鼻分泌物sIgE,32例(62.7%)患者对艾蒿过敏,12例(23.5%)对螨类过敏,3例(5.9%)对真菌过敏原过敏。局部艾蒿sIgE水平和血清艾蒿sIgE水平彼此正相关,且与VAS评分正相关。

结论

鼻炎患者鼻分泌物中的sIgE水平是用于诊断变应性鼻炎的血清sIgE的一种可靠的非侵入性替代方法。

证据水平

4。《喉镜》,128:E311 - E315,2018年。

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