Ring J, Darsow U, Gfesser M, Vieluf D
Klinik und Poliklinik für Dermatologie und Allergologie Biederstein, Technical University Munich, Germany.
Int Arch Allergy Immunol. 1997 May-Jul;113(1-3):379-83. doi: 10.1159/000237609.
The atopy patch test (APT) is a procedure involving epicutaneous patch tests with allergens known to elicit IgE-mediated reactions and the evaluation of eczematous skin lesions. APT can be performed on normal uninvolved skin without artificial manipulations such as tape stripping or use of irritants. APT has been standardized regarding the use of vehicle and dose response relationships. In several studies, approximately two thirds of patients with atopic eczema (AE) showed positive APT reactions to aeroallergens, most frequently to house dust mite. Positive APT reactions were significantly more frequent in patients with a typical air-exposed eczematous distribution pattern. Using evaporimetry to study transepidermal water loss, allergen-induced disturbance of epidermal barrier functions was found to be significantly more pronounced on APT reactions compared to classical contact allergy patch test sites in the same individual. It has been shown that with APT eczematous skin lesions can be elicited by skin contact with aeroallergens, at least in a subgroup of patients with AE, and thereby, that IgE-mediated allergy does play a role in the etiopathophysiology of this disease. Future studies should help to bring this test into clinical routine in order to establish an equivalent for 'skin provocation' comparable to nasal and bronchial provocation tests in respiratory allergy.
特应性斑贴试验（APT）是一种程序，包括用已知能引发IgE介导反应的变应原进行表皮斑贴试验以及对湿疹性皮肤损害进行评估。APT可在正常未受累皮肤进行，无需诸如胶带剥离或使用刺激物等人工操作。APT在赋形剂的使用和剂量反应关系方面已实现标准化。在多项研究中，约三分之二的特应性皮炎（AE）患者对气传变应原的APT反应呈阳性，最常见的是对屋尘螨。典型的暴露于空气的湿疹分布模式患者的APT阳性反应明显更频繁。使用蒸发测定法研究经表皮水分流失发现，与同一人经典接触性过敏斑贴试验部位相比，变应原诱导的表皮屏障功能紊乱在APT反应中明显更显著。研究表明，通过APT，至少在一部分AE患者亚组中，皮肤接触气传变应原可引发湿疹性皮肤损害，因此，IgE介导的过敏在该疾病的病因病理生理学中确实起作用。未来的研究应有助于将该试验纳入临床常规，以便建立一种与呼吸道过敏中的鼻和支气管激发试验相当的“皮肤激发试验”。
