Dannemann A, van Ree R, Kulig M, Bergmann R L, Bauer P, Forster J, Guggenmoos-Holzmann I, Aalberse R C, Wahn U
University Children's Hospital, Virchow-Clinic Berlin, Germany.
Int Arch Allergy Immunol. 1996 Nov;111(3):262-7. doi: 10.1159/000237376.
In order to investigate, whether atopic and nonatopic children show differences in their specific IgE and IgG4 immune responses to tetanus (T) and diphtheria (D) antigens, we studied 538 children who had been followed from birth on and from whom records had been kept of all immunizations.
The prevalence of eczema and asthma was registered at regular intervals and the cumulative incidence of symptoms was determined at 24 months of age. Total serum IgE and specific IgE to a panel of nine allergens as well as T- and D-specific IgE and IgG4 were determined from the 24-months blood samples.
Our results show that both atopic and nonatopic children are capable of mounting high levels of toxoid-specific IgE antibody responses. Children with cord blood IgE > 0.9 kU/1, serum IgE 10-100 kU/1 and > 100 kU/1 and at least one sensitization to an allergen at 24 months of age have significantly higher IgE responses to T and D (p < 0.001). In contrast, specific IgG4 antibody concentrations to T and D were not significantly different in children with elevated total IgE levels at 24 months. No differences in subgroups of children with or without early symptoms of atopy were observed.
Our data indicate that IgE responses to toxoids such as T and D are not limited to infants with clinical manifestations of atopy in the first 2 years of life but are related to immunological parameters of atopy.
为了研究特应性和非特应性儿童对破伤风（T）和白喉（D）抗原的特异性IgE和IgG4免疫反应是否存在差异，我们对538名自出生起就进行随访且保存了所有免疫接种记录的儿童进行了研究。
定期记录湿疹和哮喘的患病率，并在24个月龄时确定症状的累积发病率。从24个月龄时采集的血液样本中检测总血清IgE、针对一组9种过敏原的特异性IgE以及T和D特异性IgE和IgG4。
我们的结果表明，特应性和非特应性儿童都能够产生高水平的类毒素特异性IgE抗体反应。脐血IgE>0.9 kU/1、血清IgE为10 - 100 kU/1和>100 kU/1且在24个月龄时至少对一种过敏原致敏的儿童，对T和D的IgE反应显著更高（p<0.001）。相比之下，24个月时总IgE水平升高的儿童中，T和D的特异性IgG4抗体浓度没有显著差异。在有或没有特应性早期症状的儿童亚组中未观察到差异。
我们的数据表明，对T和D等类毒素的IgE反应并不局限于生命最初2年有特应性临床表现的婴儿，而是与特应性的免疫参数有关。
