虾过敏与变应性鼻炎患者临床相关性：抗 Der p 10 IgE 作为预测因子。
Clinical Relevance of Shrimp Sensitization in Patients with Allergic Rhinitis: Anti-Der p 10 IgE as Predictor.
机构信息
Group of Clinical and Experimental Allergy (GACE), "IPS Universitaria" Clinic, University of Antioquia, Medellín, Colombia.
Institute for Immunological Research, University of Cartagena, Cartagena, Colombia.
出版信息
Int Arch Allergy Immunol. 2021;182(10):971-979. doi: 10.1159/000516005. Epub 2021 Jun 4.
INTRODUCTION
Cross-reactivity between shrimp and house dust mite (HDM) proteins has been widely documented. In tropical region, shrimp (5-15%) and mite sensitization (80-95%) is prevalent in allergic patients. However, the clinical relevance of shrimp sensitization in patients with allergic rhinitis (AR) has been poorly studied. The aim of this study was to determine the prevalence and the clinical relevance shrimp IgE sensitization in AR patients sensitized to Dermatophagoides pteronyssinus.
METHODS
The study was conducted in Medellin (Colombia). A cross-sectional study in patients with AR sensitized to HDM was performed in 3 steps: (i) assessment of IgE sensitization frequency to shrimp Penaeus azteca, Litopenaeus vannamei, and tropomyosin homologous allergens rDer p 10, rPen a 1, and rLit v 1, (ii) evaluation of the clinical relevance of shrimp sensitization using oral challenge test (OCT) and (iii) identification of possible risk factors for positive-OCT results. Ethical committee approval was obtained.
RESULTS
From 443 patients with AR, 86 (19.4%) were sensitized to shrimp and 23 of them (26.7%) had shrimp allergy diagnosis. Thirty-six of the patients sensitized to shrimp (41.2%) reported not previously consumed this food and eleven of them had a positive-OCT (30.5%). There was not statistically significant difference in total IgE or sIgE (D. pteronyssinus, P. azteca, L. vannamei, rPen a 1, and rLit v 1) between OCT groups (positive vs. negative results). Anti-Der p 10 IgE was associated with risk for a positive-OCT in different multivariable scenarios.
DISCUSSION/CONCLUSION: Our results suggest that in patients with HDM-associated AR and shrimp IgE sensitization is necessary to evaluate the clinical relevance of shrimp IgE even if the patient has never consumed shrimp because of cross-reactivity. Anti-Der p 10 could be a possible biomarker of clinical relevance to shrimp sensitization and could reduce the need for OCTs.
简介
虾和屋尘螨（HDM）蛋白之间的交叉反应已被广泛记录。在热带地区，虾（5-15%）和螨致敏（80-95%）在过敏患者中很常见。然而，虾致敏在过敏性鼻炎（AR）患者中的临床相关性研究甚少。本研究旨在确定对屋尘螨过敏的 AR 患者中虾 IgE 致敏的流行率和临床相关性。
方法
本研究在麦德林（哥伦比亚）进行。对 HDM 致敏的 AR 患者进行了一项横断面研究，分为 3 个步骤：（i）评估对虾过敏原 Penaeus azteca、Litopenaeus vannamei 和肌球蛋白同源过敏原 rDer p 10、rPen a 1 和 rLit v 1 的 IgE 致敏频率，（ii）通过口服挑战试验（OCT）评估虾致敏的临床相关性，（iii）确定阳性-OCT 结果的可能危险因素。获得伦理委员会批准。
结果
在 443 例 AR 患者中，86 例（19.4%）对虾过敏，其中 23 例（26.7%）诊断为虾过敏。在 86 例虾过敏患者中，有 36 例（41.2%）报告从未食用过这种食物，其中 11 例 OCT 阳性（30.5%）。OCT 阳性组和阴性组之间的总 IgE 或 sIgE（D. pteronyssinus、P. azteca、L. vannamei、rPen a 1 和 rLit v 1）无统计学差异。在不同的多变量情况下，抗 Der p 10 IgE 与 OCT 阳性结果相关。
讨论/结论：我们的结果表明，在 HDM 相关 AR 患者中，即使患者从未食用过虾，由于交叉反应，也有必要评估虾 IgE 致敏的临床相关性。抗 Der p 10 可能是虾致敏临床相关性的一个可能的生物标志物，并可能减少 OCT 的需求。
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