Deng Shan, Yin Jia
Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Beijing Key Laboratory of Precision Diagnosis and Treatment on Allergic Diseases, Beijing, China.
World Allergy Organ J. 2019 Jun 21;12(6):100043. doi: 10.1016/j.waojou.2019.100043. eCollection 2019.
Cross-reactivity between pollen and plant foods results in low specificity of food-IgE and skin prick testing, which may cause over-diagnosis. A test that can accurately diagnose pollen-related food allergy and identify patients at risk of developing severe reactions is needed. This study evaluates basophil CD63 expression as a biomarker for diagnosis and predicting severity of mugwort pollen-related peach allergy.
Based on their allergic reactions to peach, an oral allergy symptom group (OAS, n = 15), a systemic reaction group (SR, n = 23), a peach-sensitized but tolerant group (PST, n = 21) and a non-peach-sensitized nonallergic group (NSE, n = 10) were identified among mugwort pollen allergic patients. Measurements of specific IgE to peach and its components, and basophil activation test (BAT) were performed.
Upon stimulation with peach extract, BAT in peach-allergic patients (OAS and SR groups) showed a significant dose-dependent upregulation of CD63 compared with PST patients, but showed no difference between SR and OAS groups. BAT to Pru p 3 could discriminate not only between sensitization and clinical allergy, but also between OAS and systemic reactions. BAT to Pru p 3 revealed 92% sensitivity, 95% specificity, 92% positive predictive value, and 92% negative predictive value. Receiver operating characteristic curves showed that BAT to Pru p 3 had the largest area under the curve.
In the diagnosis of mugwort pollen-related peach allergy, BAT to Pru p 3 is superior to testing for IgE specific for peach and its components. Additionally, basophil activation can predict clinical severity.
花粉与植物性食物之间的交叉反应导致食物特异性IgE和皮肤点刺试验的特异性较低，这可能会导致过度诊断。因此，需要一种能够准确诊断花粉相关食物过敏并识别有发生严重反应风险的患者的检测方法。本研究评估嗜碱性粒细胞CD63表达作为诊断和预测艾蒿花粉相关桃子过敏严重程度的生物标志物。
根据对桃子的过敏反应，在艾蒿花粉过敏患者中确定了口腔过敏症状组（OAS，n = 15）、全身反应组（SR，n = 23）、桃子致敏但耐受组（PST，n = 21）和非桃子致敏非过敏组（NSE，n = 10）。进行了对桃子及其成分的特异性IgE测量和嗜碱性粒细胞活化试验（BAT）。
用桃子提取物刺激后，桃子过敏患者（OAS组和SR组）的BAT显示，与PST患者相比，CD63有显著的剂量依赖性上调，但SR组和OAS组之间没有差异。对Pru p 3的BAT不仅可以区分致敏和临床过敏，还可以区分OAS和全身反应。对Pru p 3的BAT显示出92%的敏感性、95%的特异性、92%的阳性预测值和92%的阴性预测值。受试者工作特征曲线显示，对Pru p 3的BAT在曲线下面积最大。
在诊断艾蒿花粉相关桃子过敏时，对Pru p 3的BAT优于对桃子及其成分的特异性IgE检测。此外，嗜碱性粒细胞活化可以预测临床严重程度。
