Anania A, Massobrio A M, Cascio B, Bosso E, Cascio G
Dipartimento di Medicina Interna, Università degli Studi, Torino.
Minerva Med. 1998 Mar;89(3):77-81.
This prospective study was undertaken to assess the differences between the levels of the main plasma components of complement in allergic subjects and in those with pseudoallergic clinical manifestations.
Plasma C3 and C4 were evaluated in a total of 256 subjects examined consecutively at the allergology outpatients clinic of the Internal Medicine Division B, University of Turin. Total IgE and C1-inhibitor levels were also determined in 128 and 44 subjects respectively.
C3 and C4 levels were not significantly different (p = 0.398 and p = 0.497) in 123 subjects with a positive and 133 with a negative prick test, nor in allergic subjects with respiratory as opposed to skin symptoms (p = 0.293 and p = 0.462), whereas the C-1 inhibitor was significantly lower (p = 0.046) in the respiratory subgroup. Total IgE was positively correlated with the C3 level (p = 0.036) in 75 allergic subjects.
These findings suggest that plasma C3 and C4 values are not sufficient to discriminate IgE inflammation (positive prick test) and pseudoallergy (negative prick test) in the assessment of subjects with clinically suspected allergy. The positive correlation between IgE synthesis and C3 also points to an interaction between IgE synthesis and C3 regulation proteins in patients with IgE mediated diseases. Further investigation of other acute phase proteins (C reactive protein, fibrinogen) and the cytokines regulating their synthesis (IL-6) in such patients will help to clarify this correlation.
本前瞻性研究旨在评估过敏受试者与具有类过敏临床表现的受试者血浆中补体主要成分水平的差异。
在都灵大学内科B部过敏门诊连续检查的256名受试者中评估血浆C3和C4。还分别在128名和44名受试者中测定了总IgE和C1抑制物水平。
在123名点刺试验阳性和133名点刺试验阴性的受试者中，C3和C4水平无显著差异（p = 0.398和p = 0.497），有呼吸道症状与有皮肤症状的过敏受试者之间也无显著差异（p = 0.293和p = 0.462），而在呼吸道亚组中C1抑制物显著降低（p = 0.046）。在75名过敏受试者中，总IgE与C3水平呈正相关（p = 0.036）。
这些发现表明，在评估临床疑似过敏的受试者时，血浆C3和C4值不足以区分IgE介导的炎症（点刺试验阳性）和类过敏（点刺试验阴性）。IgE合成与C3之间的正相关也表明，在IgE介导疾病的患者中，IgE合成与C3调节蛋白之间存在相互作用。进一步研究此类患者的其他急性期蛋白（C反应蛋白、纤维蛋白原）及其合成调节细胞因子（IL-6）将有助于阐明这种相关性。
