Zhuang S J, Fan T T, Ruan X Y, Lai R L, Yan W J, Liu C Y, Lu Z W, Huang M F, Yang F H, Bao Y M
Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen518026, China Respiratory Department, Shenzhen Children' s Hospital, Shenzhen518026, China.
Respiratory Department, Shenzhen Children' s Hospital, Shenzhen518026, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Dec 6;58(12):1885-1893. doi: 10.3760/cma.j.cn112150-20240708-00545.
To investigate the distribution characteristics and analyze the clinical significance of dermatophagoides pteronyssinus allergen components in children with allergic rhinitis and asthma in Shenzhen. This study was a cross-sectional study. The clinical data of children with allergic rhinitis and asthma induced by dust mites admitted to the allergy clinic of Shenzhen Children's Hospital from 2021 to 2024 were collected and the serum sIgE levels of dermatophagoides pteronyssinus, dermatophagoides farinae (Der p, Der f) and dermatophagoides pteronyssinus components (Der p 1, Der p 2, Der p 10, Der p 23) were detected by magnetic bead chemiluminescence method. The correlation between dermatophagoides pteronyssinus allergen components and clinical data of children was analyzed. According to the diagnosis, the children were divided into allergic rhinitis (AR) group and AR with asthma (ARAS) group. According to the age, the children were divided into preschool age (5 years ≤age<7 years), school age (7 years ≤age<10 years) and adolescence (10 years ≤age≤15 years). The expression differences of dermatophagoides pteronyssinus components among AR group and ARAS group and different age groups were compared. A total of 314 children with allergic rhinitis and asthma caused by dust mites were included in the study, of whom 112 were male and 202 were female. There were 188 cases of AR and 126 cases of ARAS, aged 5-15 years, with a median age of 7.54 years and an average age of (8.02±2.24) years. BMI was 13.89-31.76 kg/m,the median BMI was 15.87 kg/m² and average BMI was (16.55±3.05) kg/m². There was not statistically significant difference in gender, age, BMI, blood eosinophils, blood basophils, FeNO, FVC and FEV1 between the AR group and the ARAS group (>0.05). There was significant difference in FEV1/FVC and small airway function indexes MMEF, MEF75%, MEF50% and MEF25% between the AR group and the ARAS group (<0.05). In the 314 children, the dermatophagoides pteronyssinus allergen components sensitization rates were in the order of Der p 1 (97.1%), Der p 2 (89.8%), Der p 23 (55.1%), Der p 10 (8.6%), and the difference in the positive rate was statistically significant (χ=658.31, <0.001). There was not significant difference in Der p 1, Der p 2 and Der p 10 among children of different ages (>0.05). There was significant difference in Der p 23 among children of different ages (χ=7.29, =0.03). A correlation analysis showed that Der p, Der f, Der p 1 and Der p 2 had a high positive correlation (<0.001). Eosinophils are positively correlated with Der p, Der f, Der p 1, Der p 2, Der p 10 and Der p 23 (<0.001). FeNO is positively correlated with Der p, Der f, and Der p 23 (<0.05). Small airway function indicators MMEF, MEF50% and MEF25% are negatively correlated with Der p, Der f and Der p 1 (<0.05). The sIgE levels of Der p, Der f, Der p 1, Der p 2 and Der p 10 in the AR group were significantly lower than those in the ARAS group (0.05). In the ARAS group, 120 cases (95.24%) showed positive results for at least 2 dermatophagoides pteronyssinus components, while 71 cases (56.35%) showed positive results for at least 3 dermatophagoides pteronyssinus components. In the AR group, 171 cases (90.96%) showed positive results for at least 2 dermatophagoides pteronyssinus components, while 94 cases (50.00%) showed positive results for at least 3 dermatophagoides pteronyssinus components. Der p 1, Der p 2 and Der p 23 may be the main dermatophagoides pteronyssinus allergen components that induce allergic rhinitis and asthma in Shenzhen City. The elevation of sIgE levels in the dermatophagoides pteronyssinus components can aggravate the severity of lower airway eosinophilic inflammation and airway obstruction. Attention should be paid to the detection of dermatophagoides pteronyssinus components in children with poor response to dust mite-allergen specific immunotherapy.
探讨深圳地区变应性鼻炎和哮喘患儿中屋尘螨变应原成分的分布特征并分析其临床意义。本研究为横断面研究。收集2021年至2024年深圳市儿童医院过敏门诊收治的尘螨诱发的变应性鼻炎和哮喘患儿的临床资料，采用磁珠化学发光法检测屋尘螨、粉尘螨（Der p、Der f）及屋尘螨成分（Der p 1、Der p 2、Der p 10、Der p 23）的血清sIgE水平。分析屋尘螨变应原成分与患儿临床资料的相关性。根据诊断将患儿分为变应性鼻炎（AR）组和变应性鼻炎合并哮喘（ARAS）组。根据年龄将患儿分为学龄前（5岁≤年龄＜7岁）、学龄期（7岁≤年龄＜10岁）和青春期（10岁≤年龄≤15岁）。比较AR组和ARAS组以及不同年龄组间屋尘螨成分的表达差异。本研究共纳入314例尘螨诱发的变应性鼻炎和哮喘患儿，其中男112例，女202例。AR患儿188例，ARAS患儿126例，年龄5 - 15岁，中位年龄7.54岁，平均年龄（8.02±2.24）岁。BMI为13.89 - 31.76 kg/m，中位BMI为15.87 kg/m²，平均BMI为（16.55±3.05）kg/m²。AR组和ARAS组在性别、年龄、BMI、血嗜酸性粒细胞、血嗜碱性粒细胞、FeNO、FVC和FEV1方面差异无统计学意义（＞0.05）。AR组和ARAS组在FEV1/FVC以及小气道功能指标MMEF、MEF75%、MEF50%和MEF25%方面差异有统计学意义（＜0.05）。在314例患儿中，屋尘螨变应原成分致敏率依次为Der p 1（97.1%）、Der p 2（89.8%）、Der p 23（55.1%）、Der p 10（8.6%），阳性率差异有统计学意义（χ=658.31，＜0.001）。不同年龄患儿在Der p 1、Der p 2和Der p 10方面差异无统计学意义（＞0.05）。不同年龄患儿在Der p 23方面差异有统计学意义（χ=7.29，=0.03）。相关性分析显示，Der p、Der f、Der p 1和Der p 2呈高度正相关（＜0.001）。嗜酸性粒细胞与Der p、Der f、Der p 1、Der p 2、Der p 10和Der p 23呈正相关（＜0.001）。FeNO与Der p、Der f和Der p 23呈正相关（＜0.05）。小气道功能指标MMEF、MEF50%和MEF25%与Der p、Der f和Der p 1呈负相关（＜0.05）。AR组Der p、Der f、Der p 1、Der p 2和Der p 10的sIgE水平显著低于ARAS组（0.05）。在ARAS组中，120例（95.24%）至少2种屋尘螨成分检测结果为阳性，71例（56.35%）至少3种屋尘螨成分检测结果为阳性。在AR组中，171例（90.96%）至少2种屋尘螨成分检测结果为阳性，94例（50.00%）至少3种屋尘螨成分检测结果为阳性。Der p 1、Der p 2和Der p 23可能是深圳市诱发变应性鼻炎和哮喘的主要屋尘螨变应原成分。屋尘螨成分中sIgE水平升高可加重下气道嗜酸性粒细胞炎症和气道阻塞的严重程度。对于尘螨变应原特异性免疫治疗反应不佳的患儿，应重视屋尘螨成分的检测。
