From the Department of Experimental Allergology and Immunology, Medical University of Bialystok, Poland.
Department of Allergology and Internal Medicine, Medical University of Bialystok, Poland.
Allergy Asthma Proc. 2020 May 1;41(3):183-191. doi: 10.2500/aap.2020.41.200002.
The presence of immunoglobulin E (IgE), which cross-reacts with allergen components, such as profilins, polcalcins, and cross-reacting carbohydrate determinants (CCD), creates a problem when selecting patients for allergen immunotherapy by using conventional methods. The aim of this study was to evaluate the prevalence of sensitization to profilins, polcalcins, and CCDs in patients with seasonal pollen allergic rhinitis. The study was performed on a group of 112 patients with seasonal pollen allergic rhinitis, ages 14 to 55 years, with sensitization to at least one seasonal allergen (IgE > 0.7 kUA/L). The presence of IgE sensitization to recombinant (r) Bet v 2, rPhl p 12, rBet v 4, rPhl p 7, and CCDs, in addition to rBet v 1, rPhl p 1, rPhl p 5, was evaluated by using a multiparameter immunoblot. Among the studied patients, 64.3, 80.4, and 41.1% were sensitized to birch, timothy grass, and mugwort pollen, respectively. Sensitization to profilins rBet v 2/Phl p 12 was demonstrated in 28.6%, to polcalcins Bet v 4/Phl p 7 in 8.9%, and to CCDs in 25%. In 29.3%, serum IgE reactivity to any of the cross-reactive components could be demonstrated. Serum IgE reactivity to rBet v 2 was always accompanied by IgE reactivity to rPhl p 12, and IgE reactivity to rBet v 4 was always accompanied by IgE reactivity to rPhl p 7. Among the patients with pollinosis co-sensitized to at least two allergen sources according to extract-based diagnosis, possible false-positive results due to sensitization to cross-reactive components were detected in 17.9%. Evaluation of sensitization to cross-reacting components may be useful in evaluation of patients with pollen allergy who are being assessed for allergen immunotherapy to optimize the constitution of their immunotherapy vaccines.
免疫球蛋白 E (IgE) 的存在与过敏原成分（如丝氨酸蛋白酶、钙结合蛋白和交叉反应性碳水化合物决定簇 [CCD]）发生交叉反应，这给使用传统方法选择变应原免疫治疗患者带来了问题。本研究旨在评估季节性花粉过敏性鼻炎患者对丝氨酸蛋白酶、钙结合蛋白和 CCD 致敏的流行情况。
该研究在 112 名年龄在 14 至 55 岁之间、至少对一种季节性过敏原（IgE > 0.7 kUA/L）致敏的季节性花粉过敏性鼻炎患者中进行。通过使用多参数免疫印迹法评估了对重组（r）Bet v 2、rPhl p 12、rBet v 4、rPhl p 7 和 CCD（除了 rBet v 1、rPhl p 1 和 rPhl p 5）的 IgE 致敏情况。
在所研究的患者中，64.3%、80.4%和 41.1%分别对桦树、豚草和艾蒿花粉过敏。28.6%对 rBet v 2/Phl p 12 丝氨酸蛋白酶、8.9%对 rBet v 4/Phl p 7 钙结合蛋白、25%对 CCD 敏感。在 29.3%的患者中，可以检测到血清 IgE 对任何一种交叉反应性成分的反应性。血清 IgE 对 rBet v 2 的反应性总是伴随着对 rPhl p 12 的 IgE 反应性，而对 rBet v 4 的反应性总是伴随着对 rPhl p 7 的 IgE 反应性。在根据提取物诊断对至少两种过敏原源同时过敏的花粉症患者中，检测到由于对交叉反应性成分的致敏而导致的可能假阳性结果为 17.9%。
评估对交叉反应性成分的致敏情况可能有助于评估正在接受变应原免疫治疗评估的花粉过敏患者，以优化其免疫治疗疫苗的组成。
