Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi.
Department of Applied Chemistry, School of Vocational Studies and Applied Sciences, Gautam Buddha University, Greater Noida U.P.
Monaldi Arch Chest Dis. 2021 May 11;91(3). doi: 10.4081/monaldi.2021.1685.
Asthma is a heterogeneous disease with distinct phenotypes. Serum tIgE, SSIgE and SPT are the methods of evaluating allergen sensitization. The present study evaluates the exposure and sensitization to cockroach (Periplaneta americana) antigens in asthma patients in a metropolitan city of India. The study enrolled 200 consecutive bronchial asthma patients, diagnosed as per GINA guidelines. As per history of exposure to cockroaches, the patients are divided in two groups as exposed and non-exposed asthmatic. All the enrolled subjects underwent SPT against common aeroallergens including cockroach, spirometry and estimation of tIgE level and SSIgE against cockroach. Out of 200 asthma patients, a total of 114 (57%) asthmatic were found SPT positive against one of the common aeroallergens, of which 68 (34%) showed SPT sensitivity against cockroach. A total of 103 (51.5%) patients were found exposed to cockroaches. In the cockroach exposed group, the mean serum tIgE was found significantly higher than the non-exposed group (569.31±224.64 vs 479.29±237 IU/ml; p=0.007). The mean SSIgE against cockroach in exposed groups was found not significant than non-expose group (4.87±11.19 vs 4.11±8.39 KUA/L; p=0.589). The mean tIgE was also not significant in atopic compared to non-atopic asthmatic (553.25±218.12 IU/ml vs 489.1±251.16 IU/ml; p=0.056). The mean SSIgE against cockroach was 5.66±10.45 KUA/L for atopic and 2.96±8.98 KUA/L for non-atopic (p=0.054). The airway obstruction was almost the same in both groups. Asthmatic patients who were exposed to cockroach and atopic had high tIgE, SSIgE levels and SPT positivity against cockroach antigen compared to non-exposed patients.
哮喘是一种具有不同表型的异质性疾病。血清总 IgE、特异性 IgE 和皮肤点刺试验是评估过敏原致敏的方法。本研究评估了印度一个大都市区哮喘患者对蟑螂（美洲大蠊）抗原的暴露和致敏情况。该研究纳入了 200 名连续的支气管哮喘患者，按照 GINA 指南进行诊断。根据接触蟑螂的病史，将患者分为暴露组和非暴露组哮喘。所有入组患者均接受常见气传过敏原（包括蟑螂）的皮肤点刺试验、肺功能检查和总 IgE 水平及特异性 IgE 检测。在 200 名哮喘患者中，共有 114 名（57%）哮喘患者对一种常见气传过敏原呈皮肤点刺试验阳性，其中 68 名（34%）对蟑螂呈皮肤点刺试验敏感性。共有 103 名（51.5%）患者接触过蟑螂。在接触蟑螂的患者中，血清总 IgE 明显高于未接触组（569.31±224.64 vs 479.29±237 IU/ml；p=0.007）。接触组的蟑螂特异性 IgE 均值与未接触组相比无显著差异（4.87±11.19 vs 4.11±8.39 KUA/L；p=0.589）。与非特应性哮喘患者相比，特应性哮喘患者的总 IgE 也无显著差异（553.25±218.12 IU/ml vs 489.1±251.16 IU/ml；p=0.056）。蟑螂特异性 IgE 为 5.66±10.45 KUA/L 的特应性患者和 2.96±8.98 KUA/L 的非特应性患者相比，（p=0.054）。两组气道阻塞程度几乎相同。与未接触蟑螂的患者相比，接触蟑螂且特应性的哮喘患者对蟑螂抗原的总 IgE、特异性 IgE 水平和皮肤点刺试验阳性率更高。
