Granerus G, Lönnqvist B, Nystrand J, Roupe G
Department of Medicine and Care, Division of Clinical Physiology, University Hospital, S-581 85 Linköping, Sweden.
Br J Dermatol. 1998 Nov;139(5):858-61. doi: 10.1046/j.1365-2133.1998.02514.x.
Serum tryptase was measured with the B12 and G5 antibody-based immunoassays in 25 adult patients with mastocytosis and in 18 controls. Twelve patients had uncomplicated cutaneous mastocytosis (urticaria pigmentosa) and 13 had urticaria pigmentosa with systemic symptoms. Tryptase levels were compared with histamine turnover estimated as urinary excretion of the main histamine metabolite tele-methylimidazoleacetic acid. Elevated B12 tryptase levels (> 20 microg/L) were found in most mastocytosis patients, including five of eight patients with only cutaneous manifestations who had a low urinary histamine metabolite excretion. This indicated a higher sensitivity for diagnosing mild mastocytosis on the basis of levels of serum tryptase as opposed to urinary methylimidazoleacetic acid. However, the serum B12 tryptase assay could not differentiate between urticaria pigmentosa patients with and without systemic disease: the measurement of histamine metabolite excretion probably reflects the mast cell burden more accurately. Serum G5 tryptase levels were generally low in both controls and mastocytosis patients.
采用基于B12和G5抗体的免疫分析法，对25例成年肥大细胞增多症患者和18例对照者的血清类胰蛋白酶进行了检测。12例患者患有单纯性皮肤肥大细胞增多症（色素性荨麻疹），13例患有伴有全身症状的色素性荨麻疹。将类胰蛋白酶水平与通过主要组胺代谢产物tele -甲基咪唑乙酸的尿排泄量估算的组胺周转率进行比较。在大多数肥大细胞增多症患者中发现B12类胰蛋白酶水平升高（> 20 μg/L），包括8例仅有皮肤表现的患者中有5例尿组胺代谢产物排泄量较低。这表明与尿甲基咪唑乙酸相比，基于血清类胰蛋白酶水平诊断轻度肥大细胞增多症具有更高的敏感性。然而，血清B12类胰蛋白酶检测无法区分有无全身性疾病的色素性荨麻疹患者：组胺代谢产物排泄量的测定可能更准确地反映肥大细胞负荷。在对照者和肥大细胞增多症患者中，血清G5类胰蛋白酶水平通常较低。
