Käck Ulrika, van Hage Marianne, Grönlund Hans, Lilja Gunnar, Asarnoj Anna, Konradsen Jon R
Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden.
Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden.
Clin Transl Allergy. 2022 May 2;12(5):e12149. doi: 10.1002/clt2.12149. eCollection 2022 May.
Sensitization to dog is an important risk factor for asthma in children, but the clinical relevance of IgE to available dog- and furry animal allergen molecules is uncertain.
Spirometry, methacholine challenge, fraction of exhaled nitric oxide, nasal challenge with dog extract and questionnaires were performed in 59 dog-sensitized children (age 10-18 years). Serum IgE to dog-, cat-, horse extracts and the allergen molecules Can f 1-6, Fel d 1, Fel d 2, Fel d 4 and Equ c 1 were evaluated.
Median numbers of positive IgE results to furry animal allergen molecules among children without asthma was 3, with asthma 5.5 and with troublesome asthma 9 (asthma vs. no asthma; = 0.039; troublesome asthma vs. no asthma; = 0.009). The odds ratio for asthma if sensitized to any lipocalin was 7.2 (95% confidence Interval: 1.44-35.9). Children with troublesome asthma had higher IgE levels to the lipocalins Can f 2, Can f 4 and Can f 6 compared to the rest of the study population (44 vs. 4.1 kU/L, = 0.015; 5.8 vs. 0.9 kU/L, = 0.018 and 1.3 vs. 0.7 kU/L, = 0.03 respectively). Furthermore, a positive nasal challenge was more common among children with troublesome asthma (83% vs. 36%, = 0.036).
Polysensitization to furry animal allergens and lipocalins is associated with asthma in dog-sensitized children. Children with troublesome asthma have higher IgE levels to several dog lipocalins than other dog sensitized children.
Polysensitization to furry animal allergens and high IgE levels to the dog lipocalins Can f 2, Can f 4 and Can f 6 is associated with asthma severity in dog dander sensitized children. Molecular allergy diagnostics may thus help the clinicians to evaluate the impact of allergic sensitization on asthma morbidity.
对狗过敏是儿童哮喘的一个重要危险因素，但IgE与现有的狗及多毛动物过敏原分子的临床相关性尚不确定。
对59名对狗过敏的儿童（年龄10 - 18岁）进行了肺活量测定、乙酰甲胆碱激发试验、呼出一氧化氮分数测定、用狗提取物进行鼻腔激发试验及问卷调查。评估了血清中针对狗、猫、马提取物以及过敏原分子Can f 1 - 6、Fel d 1、Fel d 2、Fel d 4和Equ c 1的IgE水平。
无哮喘儿童中对多毛动物过敏原分子IgE检测呈阳性的中位数为3，哮喘儿童为5.5，严重哮喘儿童为9（哮喘组与无哮喘组比较，P = 0.039；严重哮喘组与无哮喘组比较，P = 0.009）。对任何脂质运载蛋白过敏的儿童患哮喘的比值比为7.2（95%置信区间：1.44 - 35.9）。与研究中的其他人群相比，严重哮喘儿童对脂质运载蛋白Can f 2、Can f 4和Can f 6的IgE水平更高（分别为44 vs. 4.1 kU/L，P = 0.015；5.8 vs. 0.9 kU/L，P = 0.018；1.3 vs. 0.7 kU/L，P = 0.03）。此外，严重哮喘儿童中鼻腔激发试验呈阳性更为常见（83% vs. 36%，P = 0.036）。
对多毛动物过敏原和脂质运载蛋白的多价致敏与对狗过敏的儿童哮喘有关。严重哮喘儿童对几种狗脂质运载蛋白的IgE水平高于其他对狗过敏的儿童。
对多毛动物过敏原的多价致敏以及对狗脂质运载蛋白Can f 2、Can f 4和Can f 6的高IgE水平与对狗毛屑过敏儿童的哮喘严重程度有关。因此，分子过敏诊断可能有助于临床医生评估过敏致敏对哮喘发病率的影响。
