Pauli G, de Blay F, Le Mao J, Bessot J C
Hôpital Civil, Strasbourg.
Bull Acad Natl Med. 1995 Jan;179(1):67-75; discussion 75-7.
Domestic allergens, such as mite and cat allergens, are a leading cause of allergic asthma. Allergen exposure is a risk factor for sensitization. Allergens also play a major role in the development of inflammation and non specific bronchial hyperreactivity as well as in the apparition and modulation of symptomatic asthma. The development of new means of detecting allergens (i.e. immunochemical assays including monoclonal antibodies, quantitative and semiquantitative guanine measurements for mite allergens) has made possible to identify allergens sources and reservoirs. The form in which domestic allergens become airborne is important. The group I and II allergens from mites, the major cockroach allergens are carried on large particles (mean size > 10 microns diameter); in contrast, the major cat allergens are airborne on small particles (40% < 5 microns). Guanine, a metabolic excretion product of mites, is used as a marker for mite feces and is correlated with the presence of major allergens from mites. A colorimetric method (Acarex-TestR) provides a simple and inexpensive method of assaying indoor mite allergen exposure for both doctor and patient alike. By using Acarex-TestR it is possible to evaluate the mite allergen exposure for a population in a particular country. The detection of allergens sources and reservoirs, the quantification of domestic allergens has enabled the evaluation of the effect of a reduction in allergen exposure to be better assessed. Recognition of the risks, environmental control and reduction in allergen loads, should be among the objectives of asthma management.
室内过敏原，如螨虫和猫过敏原，是过敏性哮喘的主要病因。接触过敏原是致敏的一个风险因素。过敏原在炎症发展、非特异性支气管高反应性以及症状性哮喘的出现和调节中也起着重要作用。新的过敏原检测方法（即包括单克隆抗体的免疫化学检测、螨虫过敏原的鸟嘌呤定量和半定量测量）的发展使得识别过敏原来源和储存库成为可能。室内过敏原以何种形式悬浮于空气中很重要。螨虫的I类和II类过敏原、主要蟑螂过敏原附着于大颗粒（平均直径>10微米）上；相比之下，主要猫过敏原悬浮于小颗粒（40%<5微米）上。鸟嘌呤是螨虫的一种代谢排泄物，用作螨虫粪便的标志物，与螨虫主要过敏原的存在相关。一种比色法（Acarex-TestR）为医生和患者提供了一种简单且廉价的检测室内螨虫过敏原暴露的方法。通过使用Acarex-TestR，可以评估特定国家人群的螨虫过敏原暴露情况。过敏原来源和储存库的检测、室内过敏原的定量使得更好地评估减少过敏原暴露的效果成为可能。认识风险、环境控制和降低过敏原负荷，应是哮喘管理的目标之一。
