Eder Katharina, Gellrich Donata, Meßmer Catalina, Canis Martin, Gröger Moritz
Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377 Munich, Germany.
Allergy Asthma Clin Immunol. 2018 Nov 8;14:76. doi: 10.1186/s13223-018-0291-4. eCollection 2018.
Sensitization to ash pollen is underestimated in various regions. The prevalence in Germany is about 10%. However, allergy to ash pollen is widely overlooked by allergists, since the pollination period of ash and birch in central Europe closely overlap and rhinoconjunctival symptoms during April/May are often assigned to birch pollen. Component resolved analysis of the different ash allergens is not routinely available. Therefore, we would like to question the usefulness of component resolved diagnostic via olive components, as ash and olive are both part of the Oleaceae family.
113 patients with nasal provocation and skin prick test to ash were retrospectively compared regarding their specific immunoglobulin E antibody profiles with response to native ash extract, rOle e 1, nOle e 7 and rOle e 9.
In nasal provocation testing 58% of 113 patients sensitized to ash were allergic, 42% were only sensitized without showing symptoms. Skin prick testing and serology against native ash extract detected most patients sensitized to ash pollen, whereas rOle e 1 was less sensitive. However, the value of measurements of skin prick test, serology to native ash extract and rOle e 1 did not allow a differentiation between an allergy and clinically silent sensitization. Specific antibodies to nOle e 7 and rOle e 9 were only seen in individual patients and were all positive for native ash extract and rOle e 1.
Skin prick testing and serology to native extract of ash pollen are the most reliable tools to diagnose a sensitization to ash pollen for patients living in Germany. Component resolved diagnostic to the major allergen rOle e 1 as representative of the Oleaceae family is possible but was less sensitive. Diagnostic of nOle e 7 and rOle e 9 did not show any additional benefit. Regarding differentiation between allergy and clinically silent sensitization to ash pollen, provocation is the leading diagnostic tool. Concluding, in routine clinical practice the standard methods-skin prick test, serology to native ash extract and provocation testing-remain crucial in the diagnosis and differentiation of ash sensitization and allergy.
在各个地区，对白蜡树花粉的致敏情况都被低估了。在德国，其患病率约为10%。然而，过敏症专科医生普遍忽视了对白蜡树花粉的过敏，因为在中欧，白蜡树和桦树的授粉期紧密重叠，4月/5月期间的鼻结膜炎症状通常被归因于桦树花粉。目前尚无法常规进行不同白蜡树过敏原的组分分辨分析。因此，鉴于白蜡树和橄榄都属于木犀科，我们对通过橄榄组分进行组分分辨诊断的实用性提出质疑。
回顾性比较了113名对白蜡树进行鼻激发试验和皮肤点刺试验的患者针对天然白蜡树提取物、重组橄榄花粉蛋白1（rOle e 1）、天然橄榄花粉蛋白7（nOle e 7）和重组橄榄花粉蛋白9（rOle e 9）的特异性免疫球蛋白E抗体谱。
在鼻激发试验中，113名对白蜡树致敏的患者中有58%过敏，42%仅致敏但未出现症状。针对天然白蜡树提取物的皮肤点刺试验和血清学检测发现了大多数对白蜡树花粉致敏的患者，而rOle e 1的敏感性较低。然而，皮肤点刺试验、针对天然白蜡树提取物的血清学检测以及rOle e 1检测的值无法区分过敏和临床无症状致敏。仅在个别患者中检测到针对nOle e 7和rOle e 9的特异性抗体，且这些患者对天然白蜡树提取物和rOle e 1均呈阳性。
对于生活在德国的患者，皮肤点刺试验和针对白蜡树花粉天然提取物的血清学检测是诊断对白蜡树花粉致敏最可靠的工具。对作为木犀科代表的主要过敏原rOle e 1进行组分分辨诊断是可行的，但敏感性较低。对nOle e 7和rOle e 9的诊断未显示出任何额外益处。关于区分对白蜡树花粉的过敏和临床无症状致敏，激发试验是主要的诊断工具。总之，在常规临床实践中，标准方法——皮肤点刺试验、针对白蜡树花粉天然提取物的血清学检测和激发试验——在白蜡树致敏和过敏的诊断及鉴别中仍然至关重要。
