Xi Yang, Deng Yu-Qin, Li Han-Da, Jiao Wo-Er, Chen Jin, Chen Jian-Jun, Tao Ze-Zhang
Department of Otolaryngology, Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Institute of Otolaryngology, Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
J Asthma Allergy. 2024 Sep 11;17:847-862. doi: 10.2147/JAA.S453414. eCollection 2024.
Up to now, there is no generally accepted biomarker to indicate the clinical response of immunotherapy. This study mainly analyzed the correlation between eosinophil cationic protein-myeloperoxidase (ECP-MPO) test papers and other immunotherapy indices in subcutaneous immunotherapy of dust mites and to explore whether the test paper can be used as an auxiliary index to quickly evaluate the efficacy of immunotherapy.
This study included 53 participants who received subcutaneous immunotherapy at the allergy clinic of Renmin Hospital of Wuhan University and 28 control participants. Six visits were conducted during a prospective study over one year. The results of the ECP-MPO test paper, nasal secretion eosinophil smear and count, nasal secretion ECP concentration, and clinical symptom scores were collected during five follow-up visits after the start of subcutaneous immunotherapy. Th1/Th2/Th17 cytokines, chemokines, IgE, IgG4 against dust mite components, and ECP concentrations were detected in the serum of participants at baseline, six months, and one year after subcutaneous immunotherapy.
The ECP test paper is not only easy to operate, but also can effectively and quickly detect the concentrations of ECP in the nasal secretion and diagnose allergic rhinitis. Symptom score is an important index for evaluating clinical immune efficacy, during subcutaneous immunotherapy, the ECP test paper showed a positive correlation with the symptom score. Simultaneously, during immunotherapy, the changes in the chromogenic grading of the test paper were synchronized with the changes in inflammatory cytokines and eosinophilic chemokines in Th2 cells of serum dust mite IgE. The sIgG4 against dust mites weakly negatively correlated with the concentration of ECP in nasal secretions and the color classification of the ECP test paper.
The ECP-MPO test paper has a certain correlation with subcutaneous immunotherapy markers of allergic rhinitis, indicating that the ECP test paper may become an auxiliary biomarker to replace other complex laboratory tests.
迄今为止，尚无被广泛接受的生物标志物来指示免疫治疗的临床反应。本研究主要分析嗜酸性粒细胞阳离子蛋白-髓过氧化物酶（ECP-MPO）试纸与尘螨皮下免疫治疗中其他免疫治疗指标之间的相关性，并探讨该试纸是否可作为快速评估免疫治疗疗效的辅助指标。
本研究纳入了53例在武汉大学人民医院过敏门诊接受皮下免疫治疗的参与者和28例对照参与者。在为期一年的前瞻性研究中进行了6次访视。在皮下免疫治疗开始后的5次随访中，收集ECP-MPO试纸结果、鼻分泌物嗜酸性粒细胞涂片及计数、鼻分泌物ECP浓度和临床症状评分。在皮下免疫治疗基线、6个月和1年后，检测参与者血清中的Th1/Th2/Th17细胞因子、趋化因子、IgE、针对尘螨成分的IgG4以及ECP浓度。
ECP试纸不仅操作简便，而且能有效快速地检测鼻分泌物中ECP的浓度并诊断过敏性鼻炎。症状评分是评估临床免疫疗效的重要指标，在皮下免疫治疗期间，ECP试纸与症状评分呈正相关。同时，在免疫治疗期间，试纸显色分级的变化与血清尘螨IgE的Th2细胞中炎性细胞因子和嗜酸性趋化因子的变化同步。针对尘螨的sIgG4与鼻分泌物中ECP的浓度及ECP试纸的颜色分级呈弱负相关。
ECP-MPO试纸与过敏性鼻炎的皮下免疫治疗标志物有一定相关性，表明ECP试纸可能成为替代其他复杂实验室检测的辅助生物标志物。
