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[分子变应原IgE检测显示在屋尘螨特异性免疫治疗期间出现新致敏反应]

[Molecular allergen IgE tests show neosensitizaions occurring during house dust mite specific immunotherapy].

作者信息

Long Ziyi, Zhang Qidi, Zou Zhixin, Zheng Yiwu, Chen Jianjun

机构信息

Department of Otolaryngology,Affiliated Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China.

Hao Oubo Biotechnology Group Co.,Ltd.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Jul;38(7):572-577. doi: 10.13201/j.issn.2096-7993.2024.07.003.

Abstract

Neosensitizations may be occur during the allergen specific immunotherapy(AIT) due to the differences between allergen vaccine's content and a patient's molecular sensitization profile. This study investigates whether AIT with HDM extract changes the sensitization profile, whether de novo sensitization occurs, and the clinical importance of the neosensitization. Fifty-three patients with HDM allergic rhinitis ,with/without asthma, patients were received one year HDM subcutaneous AIT . Fourteen patients were recruited as control group and received only necessary medications. Serum samples were collected at baseline, 6thmoths and 12thof AIT, respectively. Serum samples were tested specific IgE against Der p, Der p 1/2/3 and Der f, Der f 1/2/3, as well as IgG4 against Der p, Der p 1/2 and Der f, Der f 1/2. VAS were collected at the time-points as well. In AIT group, Der p, Der p 1/3, and Der f 1/3 specific IgE levels were significantly higher after one-year treatment, especially for Der p 3. There were 69.2%(18/26) patients whose Der p 3 specific IgE below 0.35 kU/L at baseline but became positive(>0.35 kU/L) after treatment, that is, neosensitization occurred. All tested allergen specific IgG4 level significantly increased after one year AIT treatment and the VAS declined dramatically. However, for patients with neosensitization and without neosensitization, there were no significantly changes concerning to IgG4 level and VAS. Patients undergoing AIT might have a risk of neosensitization to the allergen components in the vaccines. However, the clinical importance of the neosensitization remains unclear and warrants further studies.

摘要

由于变应原疫苗的成分与患者的分子致敏谱存在差异,在变应原特异性免疫疗法(AIT)期间可能会发生新致敏。本研究调查了用屋尘螨提取物进行的AIT是否会改变致敏谱、是否会发生从头致敏以及新致敏的临床重要性。53例患有/未患有哮喘的屋尘螨过敏性鼻炎患者接受了为期一年的屋尘螨皮下AIT。招募了14例患者作为对照组,仅接受必要的药物治疗。分别在AIT的基线、第6个月和第12个月采集血清样本。检测血清样本中针对Der p、Der p 1/2/3和Der f、Der f 1/2/3的特异性IgE,以及针对Der p、Der p 1/2和Der f、Der f 1/2的IgG4。在这些时间点也收集了视觉模拟评分(VAS)。在AIT组中,经过一年的治疗后,Der p、Der p 1/3和Der f 1/3特异性IgE水平显著升高,尤其是Der p 3。有69.2%(18/26)的患者在基线时Der p 3特异性IgE低于0.35 kU/L,但治疗后变为阳性(>0.35 kU/L),即发生了新致敏。经过一年的AIT治疗后,所有检测的变应原特异性IgG4水平均显著升高,且VAS显著下降。然而,对于有新致敏和无新致敏的患者,IgG4水平和VAS没有显著变化。接受AIT的患者可能有对疫苗中变应原成分发生新致敏的风险。然而,新致敏的临床重要性仍不清楚,需要进一步研究。

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