Xuan B B, Tan M Y, Sun H X, Chen J J, Zhou L D, Zhang H H, Yao J M, Wang Y J, Lin J P, Sheng H M
Department of Clinical Laboratory, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200336, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Dec 6;58(12):1902-1911. doi: 10.3760/cma.j.cn112150-20240325-00247.
Analyzing the distribution characteristics of allergen sIgE in the serum of patients with respiratory and skin mucosal diseases in Shanghai City, and to provide epidemiological characteristics and diagnostic basis for the prevention and treatment of allergic respiratory and dermo-mucous diseases in Shanghai City. Adopting cross-sectional research, a total of 3 822 patients who received treatment in Tongren Hospital, Shanghai Jiao Tong University School of Medicine from July 2022 to July 2023 due to respiratory diseases or skin and dermo-mucous symptoms were included. Among them, there were 1 456 males and 2 366 females, with an age range of 1-97 years old. The median age (interquartile range) was 33 (27, 44) years old. The sIgE was detected by using immunoblotting. Statistical analysis was conducted using SPSS 22.0 software, and the comparison of count data (rates) between groups was conducted using test. The results showed that a total of 3 377 (88.4%) cases among 3 822 patients were at least one allergen sIgE positive, and 72.9% (2 788/3 822) of them were multiple allergies sIgE positive. The top five allergen sIgE positive rates were Dermatophagoides pteronyssinus (37.9%, 1 447/3 822), Dermatophagoides farinae (32.1%, 1 225/3 822), milk (31.7%, 1 211/3 822), fungi (28.3%, 1 080/3 822), and Blomia tropicdis (23.8%, 909/3 822), with only milk was a kind of food allergen. The highest positive rates within the respiratory system disease group or dermo-mucous disease group were also these five allergens, without any difference in disease categories. The positive rates of cat dandruff, Humulusscandens, and juniper/birch in the respiratory system disease group were significantly higher than those in the skin and mucous membrane disease group, while the positive rates of shrimp/crab were relatively low (11.3% 14.9%, =9.616,=0.002). Whether in the respiratory system disease group or the dermo-mucous disease group, the positive rates of Dermatophagoides pteronyssinus in male patients were significantly higher than those of females(42.6% 35.7%,41.0% 34.4%), with statistical significance (=12.515, <0.001; =5.143, =0.023), And the three allergens, Dermatophagoides farinae, cat dander, and egg white allergens are also characterized by this feature.In addition, the positive rates of milk(33.8% 30.1%, =3.911, =0.048), shrimp/crab(13.2% 10.0%, =6.423, =0.014) in the respiratory system disease group were higher in males than in females, while in the dermo-mucous disease group, dog dander(20.5% 14.6%, =6.726, =0.010) and peanuts/soybeans(10.5% 6.9%, =4.698, =0.030) showed this phenomenon. In both the respiratory system disease group and the dermo-mucous disease group, there were 6 types of inhaled allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicdis, cat dandruff, dog dander, fungi) and 4 types of food allergens (egg yolks, egg white allergens, milk, shrimp/crab). However, the positivity rate of Aspergillus fumigatus (7.2% 9.3% 10.5% 15.7%, =10.996, =0.012)in the respiratory disease group and cockroaches(4.2% 11.3% 9.6% 16.4%, =10.237, =0.017) in the skin and mucosal disease group was the lowest in the underage group. There are seasonal differences in the positivity rates of allergens, with most allergens having significantly higher positivity rates in summer and autumn. In conclusion, the most common allergens sIgE positive in patients with respiratory and dermo-mucous diseases in Shanghai City are Dermatophagoides pteronyssinus, Dermatophagoides farinae, milk, fungi, and Blomia tropicdis. The trend of allergen sIgE prevalence in the two major categories of diseases is basically consistent. Allergen sIgE distribution varies among patient populations of different gender, age or season, and clinical prevention and treatment can be based on the results of serum allergen testing.
分析上海市呼吸道及皮肤黏膜疾病患者血清中变应原特异性免疫球蛋白E（sIgE）的分布特征，为上海市过敏性呼吸道及皮肤黏膜疾病的防治提供流行病学特征及诊断依据。采用横断面研究，纳入2022年7月至2023年7月在上海交通大学医学院附属同仁医院因呼吸道疾病或皮肤及皮肤黏膜症状接受治疗的3822例患者。其中男性1456例，女性2366例，年龄范围为1~97岁。年龄中位数（四分位间距）为33（27，44）岁。采用免疫印迹法检测sIgE。使用SPSS 22.0软件进行统计分析，组间计数资料（率）的比较采用检验。结果显示，3822例患者中共有3377例（88.4%）至少有1种变应原sIgE阳性，其中72.9%（2788/3822）为多种变应原sIgE阳性。变应原sIgE阳性率排名前5位的是屋尘螨（37.9%，1447/3822）、粉尘螨（32.1%，1225/3822）、牛奶（31.7%，1211/3822）、真菌（28.3%，1080/3822）和热带无爪螨（23.8%，909/3822），其中只有牛奶是食物变应原。呼吸系统疾病组或皮肤黏膜疾病组中阳性率最高的也是这5种变应原，疾病类别间无差异。呼吸系统疾病组中猫皮屑、葎草、刺柏/桦树的阳性率显著高于皮肤黏膜疾病组，而虾/蟹的阳性率相对较低（11.3%比14.9%，χ²=9.616，P=0.002）。无论在呼吸系统疾病组还是皮肤黏膜疾病组，男性患者屋尘螨的阳性率均显著高于女性（42.6%比35.7%，41.0%比34.4%），差异有统计学意义（χ²=12.515，P<0.001；χ²=5.143，P=0.023），粉尘螨、猫皮屑和蛋清变应原这3种变应原也有此特征。此外，呼吸系统疾病组中牛奶（33.8%比30.1%，χ²=3.911，P=0.048）、虾/蟹（13.2%比10.0%，χ²=6.423，P=0.014）的阳性率男性高于女性，而在皮肤黏膜疾病组中，狗皮屑（20.5%比14.6%，χ²=6.726，P=0.010）和花生/大豆（10.5%比6.9%，χ²=4.698，P=0.030）也有此现象。在呼吸系统疾病组和皮肤黏膜疾病组中，均有6种吸入性变应原（屋尘螨、粉尘螨、热带无爪螨、猫皮屑、狗皮屑、真菌）和4种食物变应原（蛋黄、蛋清变应原、牛奶、虾/蟹）。然而，呼吸系统疾病组中烟曲霉（7.2%比9.3%比10.5%比15.7%，χ²=10.996，P=0.012）和皮肤黏膜疾病组中蟑螂（4.2%比11.3%比9.6%比16.4%，χ²=10.237，P=0.017）在未成年组中的阳性率最低。变应原阳性率存在季节差异，大多数变应原在夏季和秋季的阳性率显著更高。综上所述，上海市呼吸道及皮肤黏膜疾病患者中最常见的sIgE阳性变应原是屋尘螨、粉尘螨、牛奶、真菌和热带无爪螨。两大类疾病中变应原sIgE的流行趋势基本一致。变应原sIgE的分布在不同性别、年龄或季节的患者群体中存在差异，临床防治可依据血清变应原检测结果进行。
