Maly F E, Marti-Wyss S, Blumer S, Cuhat-Stark I, Wüthrich B
Institute of Clinical Chemistry, University Hospital Zürich, Switzerland.
J Investig Allergol Clin Immunol. 1997 Jul-Aug;7(4):217-24.
Cross-linking IgE on basophils is known to cause both sulfidoleukotriene (sLT) generation and histamine release. We recently developed an ELISA to determine sulfidoleukotriene generation by blood mononuclear cells which employs pretreatment with IL-3 to enhance leukotriene generation (cellular antigen stimulation test, CAST). Here, we compared the CAST and whole blood histamine release in response to honey bee/yellow jacket venom (BV/YJV) in 23 patients clinically suspected of type-I allergy to these venoms. Of these, 17 were diagnosed as "definitive venom allergics," defined by a positive skin test at 100 ng/ml of venom or less. The six in whom such skin reactivity was absent were labelled "suspected venom allergics." Both venoms stimulated sulfidoleukotriene generation and histamine release also from control individuals (n = 10). In patients, insect venoms generally stimulated histamine release and sulfidoleukotriene generation in excess of the mean + 3 SD of values obtained with control individuals. However, about half of the patients reacted predominantly with either histamine release or sulfidoleukotriene generation. No overall correlation was found between threshold doses necessary to stimulate sulfidoleukotriene generation (ThsLT) and histamine release (ThHist). (Linear correlation coefficients between ThsLT and ThHist were -0.02 for honey bee venom and 0.13 for yellow jacket, n = 23). Both findings are in contrast to the concept that these responses occur in parallel. From results with "definitive venom allergics," CAST sensitivity was calculated as 100% for honey bee venom and 83% for yellow jacket, and that of the histamine release assay as 62.5% for honey bee venom and 50% for yellow jacket. Specificity of the CAST was calculated as 77% for honey bee venom and 100% for yellow jacket, and that of the histamine release assay as 44% for honey bee venom and 60% for yellow jacket. Thus, CAST results are closer to skin test results than to those of the whole blood histamine release assay.
已知嗜碱性粒细胞上的IgE交联会导致硫代白三烯（sLT）生成和组胺释放。我们最近开发了一种酶联免疫吸附测定法（ELISA），用于测定血液单核细胞产生的硫代白三烯，该方法采用白细胞介素-3预处理以增强白三烯生成（细胞抗原刺激试验，CAST）。在此，我们比较了23例临床怀疑对这些毒液有I型过敏的患者对蜜蜂/黄蜂毒液（BV/YJV）的CAST和全血组胺释放情况。其中，17例被诊断为“明确的毒液过敏者”，定义为毒液浓度为100 ng/ml或更低时皮肤试验呈阳性。6例无这种皮肤反应性的患者被标记为“疑似毒液过敏者”。两种毒液均刺激了硫代白三烯生成以及对照组个体（n = 10）的组胺释放。在患者中，昆虫毒液通常刺激组胺释放和硫代白三烯生成，其水平超过对照组个体所得值的平均值 + 3标准差。然而，约一半的患者主要表现为组胺释放或硫代白三烯生成。刺激硫代白三烯生成所需的阈值剂量（ThsLT）与组胺释放所需的阈值剂量（ThHist）之间未发现总体相关性。（蜜蜂毒液的ThsLT与ThHist之间的线性相关系数为 -0.02，黄蜂毒液为0.13，n = 23）。这两个发现均与这些反应平行发生的概念相反。根据“明确的毒液过敏者”的结果，计算得出蜜蜂毒液的CAST敏感性为100%，黄蜂毒液为83%，组胺释放试验的敏感性分别为蜜蜂毒液62.5%，黄蜂毒液50%。CAST对蜜蜂毒液的特异性计算为77%，黄蜂毒液为100%，组胺释放试验对蜜蜂毒液的特异性为44%，黄蜂毒液为60%。因此，CAST结果比全血组胺释放试验结果更接近皮肤试验结果。
