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血清IgE抑制活性与蒿属花粉皮下免疫疗法治疗变应性鼻炎疗效的关系:一项初步自身对照研究

Relationship between serum inhibitory activity for IgE and efficacy of Artemisia pollen subcutaneous immunotherapy for allergic rhinitis: a preliminary self-controlled study.

作者信息

Wang Wenping, Yin Jinshu, Wang Xueyan, Ma Tingting, Lan Tianfei, Song Qingkun, Guo Yifan

机构信息

1Department of Otolaryngology, Head and Neck Surgery, Peking University Ninth School of Clinical Medicine, Beijing, China.

2Department of Otolaryngology, Head and Neck Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.

出版信息

Allergy Asthma Clin Immunol. 2020 Mar 4;16:18. doi: 10.1186/s13223-020-0416-4. eCollection 2020.

Abstract

BACKGROUND

Biomarkers of clinical efficacy for subcutaneous immunotherapy (SCIT) on allergic rhinitis (AR) have not been identified yet. This study aims to assess the clinical relevance of serum inhibitory activity for IgE by the method of enzyme-linked immunosorbent facilitated antigen binding (ELIFAB) during SCIT for Artemisia-sensitized AR patients.

METHODS

19 AR patients were studied who had undergone Artemisia-specific SCIT for more than 8 months (19.68 months on average, ranging from 9 to 33 months). Peripheral bloods were collected before and after treatment. The serum inhibitory activity for IgE was tested by ELIFAB and the level of Artemisia-specific IgG4 (Artemisia-sIgG4) was determined by ELISA. Clinical improvement was evaluated based on the symptom scores and rescue medication use (SMS). The 2-tailed Wilcoxon signed-rank test and the Spearman rank test (two-tailed) were used to analyze data by using SPSS 20.0, with P values of less than 0.05 considered as significant.

RESULTS

The SMS decreased significantly after SCIT (before: 12.79 ± 4.250, after: 6.11 ± 3.828, P = 0.000 < 0.01), the treatment was remarkably effective for 6 patients, effective for 10 and ineffective for 3, along with a total effective rate 84.21%. The serum inhibitory activity for IgE increased significantly after SCIT (P < 0.05) and was correlated with the levels of Artemisia-sIgG4 (r = - 0.501, P = 0.002 < 0.01). The levels of Artemisia-sIgG4 elevated dramatically after treatment (P < 0.01) and were related with the duration of treatment (r = 0.558, P = 0.000 < 0.01). But there was no relationship between clinical improvements and the serum inhibitory activity for IgE.

CONCLUSIONS

The serum inhibitory activity for IgE increased significantly after SCIT, however, there was no correlation between it and clinical improvements by statistics analysis. So whether the serum inhibitory activity for IgE can act as biomarker of efficacy for SCIT or not needs to be studied further.

摘要

背景

皮下免疫疗法(SCIT)治疗过敏性鼻炎(AR)的临床疗效生物标志物尚未明确。本研究旨在评估蒿属致敏AR患者在SCIT期间通过酶联免疫吸附促进抗原结合法(ELIFAB)检测的血清IgE抑制活性的临床相关性。

方法

研究19例接受蒿属特异性SCIT超过8个月(平均19.68个月,范围9至33个月)的AR患者。在治疗前后采集外周血。通过ELIFAB检测血清IgE抑制活性,通过ELISA测定蒿属特异性IgG4(蒿属sIgG4)水平。基于症状评分和急救药物使用情况(SMS)评估临床改善情况。使用SPSS 20.0软件,采用双尾Wilcoxon符号秩检验和Spearman秩检验(双尾)进行数据分析,P值小于0.05被认为具有统计学意义。

结果

SCIT后SMS显著降低(治疗前:12.79±4.250,治疗后:6.11±3.828,P = 0.000 < 0.01),治疗显效6例,有效10例,无效3例,总有效率84.21%。SCIT后血清IgE抑制活性显著增加(P < 0.05),且与蒿属sIgG4水平相关(r = -0.501,P = 0.002 < 0.01)。治疗后蒿属sIgG4水平显著升高(P < 0.01),且与治疗持续时间相关(r = 0.558,P = 0.000 < 0.01)。但临床改善与血清IgE抑制活性之间无相关性。

结论

SCIT后血清IgE抑制活性显著增加,但经统计学分析其与临床改善无相关性。因此,血清IgE抑制活性能否作为SCIT疗效的生物标志物有待进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/807b/7057474/05cca1cc1b14/13223_2020_416_Fig1_HTML.jpg

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