Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Allergol Int. 2018 Oct;67(4):435-441. doi: 10.1016/j.alit.2018.07.002. Epub 2018 Jul 31.
Sweat allergy is defined as a type I hypersensitivity against the contents of sweat, and is specifically observed in patients with atopic dermatitis (AD) and cholinergic urticaria (CholU). The allergic reaction is clinically revealed by positive reactions in the intradermal skin test and the basophil histamine release assay by sweat. A major histamine-releasing antigen in sweat, MGL_1304, has been identified. MGL_1304 is produced at a size of 29 kDa by Malassezia (M.) globosa and secreted into sweat after being processed and converted into the mature form of 17 kDa. It induces significant histamine release from basophils of patients with AD and/or CholU with MGL_1304-specific IgE, which is detected in their sera. Patients with AD also show cross-reactivity to MGL_1304-homologs in Malassezia restricta and Malassezia sympodialis, but MGL_1304 does not share cross antigenicity with human intrinsic proteins. Malassezia or its components may penetrate the damaged epidermis of AD lesions and interact with the skin immune system, resulting in the sensitization and reaction to the fungal antigen. As well as the improvement of impaired barrier functions by topical interventions, approaches such as anti-microbial treatment, the induction of tolerance and antibody/substance neutralizing the sweat antigen may be beneficial for the patients with intractable AD or CholU due to sweat allergy. The identification of antigens other than MGL_1304 in sweat should be the scope for future studies, which may lead to better understanding of sweat allergy and therapeutic innovations.
汗过敏被定义为针对汗液内容物的 I 型超敏反应，特别是在特应性皮炎（AD）和胆碱能性荨麻疹（CholU）患者中观察到。过敏反应通过汗液的皮内皮肤试验和嗜碱性粒细胞组胺释放试验阳性反应在临床上显现。已鉴定出汗水中的一种主要的组胺释放抗原，MGL_1304。M. globosa 产生大小为 29 kDa 的 MGL_1304，并在加工和转化为 17 kDa 的成熟形式后分泌到汗液中。它诱导 AD 和/或 CholU 患者的嗜碱性粒细胞释放大量组胺，这些患者的血清中存在针对 MGL_1304 的特异性 IgE。AD 患者也对 Malassezia restricta 和 Malassezia sympodialis 中的 MGL_1304 同源物表现出交叉反应性，但 MGL_1304 与人类内在蛋白没有交叉抗原性。马拉色菌或其成分可能穿透 AD 病变受损的表皮，并与皮肤免疫系统相互作用，导致对真菌抗原的致敏和反应。除了通过局部干预改善受损的屏障功能外，抗微生物治疗、诱导耐受和中和汗液抗原的抗体/物质等方法可能对难治性 AD 或 CholU 患者有益，原因是汗过敏。在汗水中鉴定除 MGL_1304 以外的抗原应该是未来研究的范围，这可能有助于更好地了解汗过敏和治疗创新。
