重组烟曲霉变应原I/a在皮肤试验和血清学检测中的诊断价值

Diagnostic value of recombinant Aspergillus fumigatus allergen I/a for skin testing and serology.

作者信息

Moser M, Crameri R, Brust E, Suter M, Menz G

机构信息

Swiss Institute of Allergy and Asthma Research, Davos-Platz.

出版信息

J Allergy Clin Immunol. 1994 Jan;93(1 Pt 1):1-11. doi: 10.1016/0091-6749(94)90227-5.

DOI:10.1016/0091-6749(94)90227-5

PMID:7508461

Abstract

BACKGROUND

We report a clinical study comparing the recombinant Aspergillus fumigatus allergen I/a (rAsp f I/a) to two commercial A. fumigatus extracts in skin prick tests, intradermal tests, and serologic assays.

METHODS

Patients with allergic bronchopulmonary aspergillosis and A. fumigatus-allergic patients with asthma, and control subjects, including allergic patients with asthma without allergy to A. fumigatus and healthy subjects, were investigated.

RESULTS

All patients with allergic bronchopulmonary aspergillosis (n = 15) reacted to skin prick tests with the commercial extracts, and eight were sensitized to rAsp f I/a. Of 10 patients with well-characterized A. fumigatus-allergic asthma nine showed positive skin prick test results to at least one of the commercial extracts, and five reacted to rAsp f I/a. There was a strong correlation between skin test reactivity to rAsp f I/a and rAsp f I/a-specific serum IgE as determined by an antigen-specific ELISA. The healthy control subjects (n = 7) and allergic patients with asthma without A. fumigatus allergy (n = 6) did not react in skin prick and intradermal tests to rAsp f I/a, nor did they have detectable amounts of rAsp f I/a-specific IgE. In addition, patients with allergic bronchopulmonary aspergillosis showed significant elevated levels of rAsp f I/a-specific IgG4 and IgG1 but no significant differences in rAsp f I/a-specific serum IgA levels when compared with the healthy control subjects.

CONCLUSIONS

The data show that rAsp f I/a is a major allergen with biologic relevance in some A. fumigatus-allergic individuals as evaluated by skin prick tests, intradermal tests, or serologic methods. Furthermore, no discrepancies were observed between skin test results and rAsp f I/a-specific IgE. Hence the correlation between rAsp f I/a skin test results and serologic data indicates the potential of recombinant allergens for clinical applications and diagnosis of allergies.

摘要

背景

我们报告一项临床研究，该研究在皮肤点刺试验、皮内试验和血清学检测中，将重组烟曲霉变应原I/a（rAsp f I/a）与两种市售烟曲霉提取物进行了比较。

方法

对患有变应性支气管肺曲霉病的患者、对烟曲霉过敏的哮喘患者以及对照受试者进行了研究，对照受试者包括对烟曲霉无过敏的哮喘过敏患者和健康受试者。

结果

所有变应性支气管肺曲霉病患者（n = 15）对市售提取物的皮肤点刺试验均有反应，8例对rAsp f I/a致敏。在10例特征明确的烟曲霉过敏性哮喘患者中，9例对至少一种市售提取物的皮肤点刺试验结果呈阳性，5例对rAsp f I/a有反应。通过抗原特异性ELISA测定，对rAsp f I/a的皮肤试验反应性与rAsp f I/a特异性血清IgE之间存在强相关性。健康对照受试者（n = 7）和对烟曲霉无过敏的哮喘过敏患者（n = 6）在皮肤点刺和皮内试验中对rAsp f I/a无反应，且未检测到rAsp f I/a特异性IgE。此外，与健康对照受试者相比，变应性支气管肺曲霉病患者的rAsp f I/a特异性IgG4和IgG1水平显著升高，但rAsp f I/a特异性血清IgA水平无显著差异。

结论

数据表明，通过皮肤点刺试验、皮内试验或血清学方法评估，rAsp f I/a是某些烟曲霉过敏个体中具有生物学相关性的主要变应原。此外，皮肤试验结果与rAsp f I/a特异性IgE之间未观察到差异。因此，rAsp f I/a皮肤试验结果与血清学数据之间的相关性表明重组变应原在临床应用和过敏诊断中的潜力。