van Ree R, Antonicelli L, Akkerdaas J H, Garritani M S, Aalberse R C, Bonifazi F
Central Laboratory, The Netherlands Red Cross Blood Transfusion Service, Amsterdam, The Netherlands.
Allergy. 1996 Feb;51(2):108-13.
Sera of 17 patients receiving immunotherapy for house-dust mite allergy were tested for IgE antibodies against snail and shrimp. Serum samples were taken at the start of immunotherapy and 14-20 months later. While the average IgE response to mite, Der p 1, and Der p 2 did not alter significantly, the average response to snail showed a significant increase. This included two conversions from negative to strongly positive. These novel IgE antibodies against snail were shown to be cross-reactive with mite. Three patients had a positive RAST for shrimp. For one of them, a strong increase of IgE against shrimp (and snail) was observed. In 2/3 snail/shrimp-positive sera, IgE antibodies against the cross-reactive allergen tropomyosin from mite, snail, and shrimp were demonstrated. A clear IgE response to snail (> 10% binding in a snail RAST) was confirmed by a positive skin prick test (SPT) for 6/10 patients. The two patients with antitropomyosin IgE also had a positive SPT for shrimp, and demonstrated the oral allergy syndrome (OAS) after eating shrimp. The observations in this study indicate that house-dust mite immunotherapy is accompanied by the induction of IgE against foods, including tropomyosin-reactive IgE. Food allergy (OAS) was observed in patients that had IgE antibodies against this cross-reactive allergen. In conclusion, induction of IgE during mite immunotherapy might occasionally cause allergy to foods of invertebrate animal origin.
对17名接受屋尘螨过敏免疫治疗的患者的血清进行了针对蜗牛和虾的IgE抗体检测。在免疫治疗开始时以及14 - 20个月后采集血清样本。虽然对螨、Der p 1和Der p 2的平均IgE反应没有显著改变，但对蜗牛的平均反应显示出显著增加。这包括两例从阴性转变为强阳性的情况。这些针对蜗牛的新型IgE抗体被证明与螨存在交叉反应。三名患者对虾的RAST检测呈阳性。其中一名患者，观察到针对虾（和蜗牛）的IgE显著增加。在2/3蜗牛/虾阳性血清中，证实存在针对来自螨、蜗牛和虾的交叉反应性变应原原肌球蛋白的IgE抗体。通过皮肤点刺试验（SPT), 6/10的患者对蜗牛有明确的IgE反应（在蜗牛RAST中结合>10%）得到证实。两名患有抗原肌球蛋白IgE的患者对虾的SPT也呈阳性，并在食用虾后出现了口腔过敏综合征（OAS）。本研究中的观察结果表明，屋尘螨免疫治疗伴随着抗食物IgE的诱导，包括对原肌球蛋白反应性IgE。在具有针对这种交叉反应性变应原的IgE抗体的患者中观察到食物过敏（OAS）现象。总之,螨免疫治疗期间IgE诱导偶尔可能导致对无脊椎动物源性食物的过敏反应。
