Department of Pediatrics, Second Hospital of Tianjin Medical University, Tianjin, China.
College of Medical Laboratory Science, Tianjin Medical University, Tianjin, China.
Scand J Immunol. 2022 Aug;96(2):e13168. doi: 10.1111/sji.13168. Epub 2022 Apr 14.
It aims to detect basophil activation ratio (%CD63 ) in peripheral blood of children with allergic asthma and rhinitis by using flow cytometry (FCM), so as to analyse the application values and clinical relevance of the basophil activation test (BAT) in diagnosis of Dermatophagoides farinae (Derf) sensitization and monitoring therapeutic efficacy of subcutaneous immunotherapy (SCIT). It was a prospective study. From the newly diagnosed children with asthma and rhinitis in our paediatric clinic, 39 patients diagnosed Derf sensitization and 15 patients not allergic to Derf were enrolled; another 4 healthy children were taken as control group. Using Derf extracts in concentration of 1, 10 μg/mL and 100 μg/mL as the stimulus, BAT results were expressed as %CD63 in diagnosis of Derf sensitization and its correlation with skin prick tests (SPT), serum total IgE (tIgE), specific IgE (sIgE), sIgE/tIgE, specific IgG4 (sIgG4), FEV1%pred in pulmonary ventilation function, exhaled nitric oxide (FeNO), children asthma control test (C-ACT) and visual analogue scale (VAS) were observed. In sensitization group, %CD63 , sIgG4 and clinical indicators were detected again from patients who had received SCIT to analyse their internal connections. The average levels of %CD63 in 3 concentrations showed an increasing concentration-dependent trend overall. %CD63 in sensitization group was significantly higher than that in the other 2 groups. The analysis of ROC for Derf sensitization showed the area under the curve (AUC) for BAT in 3 concentrations was higher than that for sIgE whose AUC is 0.893. %CD63 was positively correlated with SPT grade, sIgE, sIgE/tIgE and VAS, and negatively correlated with C-ACT. In patients receiving SCIT, %CD63 became lower and sIgG4 level became higher than pretreatment. There was no obvious change in sIgG4 in those who had not received SCIT. BAT is a reliable and non-invasive tool for diagnosis of Derf sensitization in children with asthma and rhinitis. CD63-based BAT has clinical value to monitor outcome of SCIT, and the change in basophil activation is inherently related to induction of sIgG4.
目的 通过流式细胞术（FCM）检测过敏性哮喘和鼻炎患儿外周血嗜碱性粒细胞激活率（%CD63），分析嗜碱性粒细胞激活试验（BAT）在诊断屋尘螨（Derf）致敏及监测皮下免疫治疗（SCIT）疗效中的应用价值及临床相关性。该研究为前瞻性研究。纳入我院儿科门诊新诊断的哮喘和鼻炎患儿，根据 Derf 致敏情况分为 39 例 Derf 致敏患儿和 15 例非 Derf 过敏患儿，另选取 4 例健康儿童作为对照组。采用 1、10 μg/mL 和 100 μg/mL 的 Derf 提取物作为刺激物，以%CD63 表示 BAT 结果，用于诊断 Derf 致敏，并与皮肤点刺试验（SPT）、血清总 IgE（tIgE）、特异性 IgE（sIgE）、sIgE/tIgE、特异性 IgG4（sIgG4）、肺通气功能 FEV1%pred、呼出气一氧化氮（FeNO）、儿童哮喘控制测试（C-ACT）和视觉模拟量表（VAS）进行相关性观察。在致敏组中，对接受 SCIT 的患者再次检测%CD63、sIgG4 和临床指标，分析其内在联系。在 3 种浓度下，%CD63 的平均水平总体呈递增的浓度依赖性趋势。致敏组%CD63 明显高于其他 2 组。Derf 致敏的 ROC 分析显示，3 种浓度的 BAT 的曲线下面积（AUC）均高于 AUC 为 0.893 的 sIgE。%CD63 与 SPT 分级、sIgE、sIgE/tIgE 和 VAS 呈正相关，与 C-ACT 呈负相关。接受 SCIT 的患者，%CD63 降低，sIgG4 水平升高，且高于治疗前；未接受 SCIT 的患者，sIgG4 无明显变化。BAT 是一种可靠的、非侵入性的儿童哮喘和鼻炎患者 Derf 致敏诊断工具。基于 CD63 的 BAT 对监测 SCIT 疗效具有临床价值，嗜碱性粒细胞激活的变化与 sIgG4 的诱导具有内在相关性。
