Brand Paul L P, Brohet Richard M, Schwantje Olof, Dikkeschei Lambert D
Isala Academy, Department of Medical Education and Faculty Development, Isala Hospital, Zwolle, The Netherlands.
Wenckebach Institute for Medical Education, University Medical Centre, Groningen, The Netherlands.
Allergol Immunopathol (Madr). 2022 Mar 1;50(2):131-141. doi: 10.15586/aei.v50i2.598. eCollection 2022.
Allergen component sensitisation testing is becoming increasingly important in the diagnosis of peanut allergy. The aim of the present study was to evaluate the relationship between sensitisation and symptoms of allergic disease in children by testing a large panel of inhalants, food allergens, and allergen components.
For 287 children visiting our laboratory for allergy testing, symptoms of allergic disease were recorded by standardised validated questionnaires. Specific IgE to 11 whole allergens was assessed by ImmunoCAP, and to 112 allergen components by ISAC ImmunoCAP assay. We used latent class analysis (LCA) to distinguish clinical phenotypes.
Inhalant and food allergen sensitisation was common, irrespective of the children's allergic symptom type. Less than 10% of the variance in symptom scores was explained by variations in the number of allergens (components) that the child was sensitised to. In LCA, 135 children (50.2%) had mild allergy, with few symptoms and sensitisation to no or few allergens, 74 children (27.5%) had more symptoms and sensitisation to inhalant allergens (respiratory allergy) and 60 children (22.3%) showed polysensitisation to a median of six allergens and had more severe symptoms of different organ systems. Adding allergen component test results to LCA failed to result in identifiable classes of allergic disease in children.
In this group of children with allergic symptoms, referred for allergy testing by their physician, broad screening for allergen component sensitisation did not contribute to distinguishing phenotypes of allergic disease.
变应原成分致敏检测在花生过敏诊断中变得越来越重要。本研究的目的是通过检测一大组吸入性变应原、食物变应原和变应原成分，评估儿童致敏与过敏性疾病症状之间的关系。
对于287名到我们实验室进行过敏检测的儿童，通过标准化的有效问卷记录过敏性疾病症状。采用免疫捕获法评估对11种全变应原的特异性IgE，采用ISAC免疫捕获法评估对112种变应原成分的特异性IgE。我们使用潜在类别分析（LCA）来区分临床表型。
无论儿童的过敏症状类型如何，吸入性和食物变应原致敏都很常见。儿童对变应原（成分）致敏数量的变化只能解释不到10%的症状评分差异。在潜在类别分析中，135名儿童（50.2%）患有轻度过敏，症状较少，对无或少数变应原致敏；74名儿童（27.5%）有更多症状，对吸入性变应原致敏（呼吸道过敏）；60名儿童（22.3%）对中位数为6种变应原多价致敏，且不同器官系统症状更严重。将变应原成分检测结果添加到潜在类别分析中，未能在儿童中识别出可区分的过敏性疾病类别。
在这组由医生转诊进行过敏检测的有过敏症状的儿童中，对变应原成分致敏进行广泛筛查无助于区分过敏性疾病的表型。
