对参与免疫疗法试验的哮喘患者家庭尘螨暴露情况以及特异性IgE和IgG抗体水平的评估。

Evaluation of household dust mite exposure and levels of specific IgE and IgG antibodies in asthmatic patients enrolled in a trial of immunotherapy.

作者信息

Rose G, Arlian L, Bernstein D, Grant A, Lopez M, Metzger J, Wasserman S, Platts-Mills T A

机构信息

Division of Allergy and Clinical Immunology, University of Virginia Medical Center, Charlottesville 22908, USA.

出版信息

J Allergy Clin Immunol. 1996 May;97(5):1071-8. doi: 10.1016/s0091-6749(96)70260-9.

DOI:10.1016/s0091-6749(96)70260-9

PMID:8626984

Abstract

BACKGROUND

Monitoring the response to immunotherapy entails understanding exposure to relevant allergens. For the major indoor allergens, this requires sampling of dust from the patient's house. The objectives of this study were to measure indoor allergen levels during a controlled trial of dust mite immunotherapy for asthma and to relate these results to serum antibody levels.

METHODS

Eighty-eight asthmatic patients with mite allergy from seven geographic areas in the United States were enrolled in and completed a course of immunotherapy with Dermatophagoides extract or placebo control. Sensitization was evaluated by quantitative measurements of IgG and IgE antibodies. Dust samples were assayed for group I mite (Der p 1 and Der f 1), cat (Fel d 1), and cockroach (Bla g 1) allergens by monoclonal antibody-based ELISA.

RESULTS

Over the 4 years of the study, each of the houses had at least one sample that contained more than 2 micrograms of group I mite allergen per gram of dust. Mean mite allergen levels, however, varied over a wide range, from 0.2 microgram/gm or less to more than 50 micrograms/gm. IgE antibodies to mite were present in sera from 78% of the patients, whereas IgE antibodies to cat and cockroach allergens were found in sera from 34% and 11% of patients, respectively. Sixty-four percent of the patients had exposure and sensitization to mite, whereas the comparable figure for each of the other allergens was 5%.

CONCLUSIONS

Examination of the results suggested that allergen exposure, relative to a trial of immunotherapy, could be expressed as (1) the maximum level found in the house, (2) the percentage of sites having greater than 2 micrograms/gm, or (3) the mean value at the site with the maximum level. This report provides a background for evaluating the clinical results of immunotherapy in these patients and a model for the way in which sensitization and exposure should be monitored in studies of this kind.

摘要

背景

监测免疫疗法的疗效需要了解对相关过敏原的暴露情况。对于主要的室内过敏原，这需要对患者家中的灰尘进行采样。本研究的目的是在一项针对哮喘的尘螨免疫疗法对照试验中测量室内过敏原水平，并将这些结果与血清抗体水平相关联。

方法

来自美国七个地理区域的88名对螨过敏的哮喘患者参加并完成了用粉尘螨提取物或安慰剂对照的免疫疗法疗程。通过定量测量IgG和IgE抗体来评估致敏情况。通过基于单克隆抗体的ELISA法检测灰尘样本中的I组螨（Der p 1和Der f 1）、猫（Fel d 1）和蟑螂（Bla g 1）过敏原。

结果

在研究的4年中，每个家庭至少有一个样本每克灰尘中含有超过2微克的I组螨过敏原。然而，平均螨过敏原水平变化范围很广，从0.2微克/克或更低到超过50微克/克。78%的患者血清中存在针对螨的IgE抗体，而分别有34%和11%的患者血清中发现针对猫和蟑螂过敏原的IgE抗体。64%的患者暴露于螨并对其致敏，而其他每种过敏原的相应比例为5%。