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　　原标题：尘螨主要过敏原在过敏原免疫治疗过程中对特异性IgG4应答有重要作用
　　①背景：在过敏原特异性免疫治疗(AIT)期间，过敏原特异性IgG4增加。在本研究中，我们研究了在AIT过程中针对尘螨个体主要过敏原的特异性IgG4。②方法：对尘螨敏感的变应性鼻炎(52例)患者，采用标准化的螨虫提取物进行皮下免疫治疗。仅接受药物治疗的对尘螨敏感的过敏性鼻炎患者作为对照(n=14)。分别在AIT前、6个月和12个月后检测各组对Dp、d.farina(Df)及相应的主要过敏原(Dp1和Df1)和2组(Dp2和Df2)的特异性IgE和IgG4。
　　③结果：免疫治疗组的症状和药物综合评分明显下降。在AIT过程中，对Dp1、Df1、Dp2和Df2过敏原的特异性IgG4表达显著增加(Dp: 0.3、0.99、2.72;Dp1: 0.16、0.67、2.04;Dp2: 0.10、0.49、1.49;Df: 0.38, 1.04, 2.62;Df1: 0.12、0.37、1.01;Df2: 0.1 0.44 1.27 (AIT前、6个月、12个月 mgA/L)。在尘螨提取物IgG4与个体亚群过敏原IgG4的相关性中，两种浓度(12个月后:Dp-Dp1: r=0.99;Dp-Dp2: r = 0.93;Df-Df1: r = 0.93;Df-Df2: r=0.95)和增长水平(12个月后:Dp-Dp1: r=0.69;Dp-Dp2: r = 0.59;Df-Df1: r = 0.90;Df-Df2: r=0.77 (P<0.0001 for all)均存在明显的相关性。在同一检测仪器(UniCAP系统)下，Df1和Df2 IgG4对Df特异性IgG4反应的贡献率为87%，而Dp1和Dp2在AIT治疗12个月时对Dp IgG4反应的贡献率为130%。④结论：我们的研究结果强调了主要过敏原在AIT标准化和设计中的重要性
延伸阅读
JACI                                                         
House Dust Mite Major Allergens Contributes Significantly to Specific IgG4 Response during Allergen Immunotherapy
DOI: https://doi.org/10.1016/j.jaci.2015.12.1244
Abstract:
Rationale
Allergen-specific IgG4 increases during allergen specific immunotherapy (AIT). In this study, specific IgG4 against the individual major allergens of dust mites during AIT was investigated.
Methods
Patients of allergic rhinitis (n=52) sensitized to dust mite were treated with subcutaneous immunotherapy using standardized D. pteronyssinus (Dp) extract. Patients with allergic rhinitis (n=14) sensitized to dust mites who received medications alone were controls. Specific IgE and IgG4 against Dp, D.farina(Df) and corresponding major allergens of group 1 (Dp1 and Df1) and group 2 (Dp2 and Df2) were measured before AIT, 6 months and 12 months later.
Results
Combined symptom and medication scores significantly decreased in immunotherapy group. Specific IgG4 against Dp1, Df1, Dp2 and Df2 allergens increased significantly during AIT (Dp: 0.3, 0.99, 2.72; Dp1: 0.16, 0.67, 2.04; Dp2: 0.10, 0.49, 1.49; Df: 0.38, 1.04, 2.62; Df1: 0.12, 0.37, 1.01; Df2: 0.1, 0.44, 1.27. before AIT, 6 months and 12months later respectively, mgA/L). Of the correlations between dust mite extract IgG4 and the individual subgroup allergen IgG4, it was shown that there were strong correlations in terms of both concentrations (after 12 months: Dp-Dp1: r=0.99; Dp-Dp2: r=0.93; Df-Df1: r=0.93; Df-Df2: r=0.95) and levels of increase (after 12 months: Dp-Dp1: r=0.69; Dp-Dp2: r=0.59; Df-Df1: r=0.90; Df-Df2: r=0.77) (P<0.0001 for all). With the same testing instrument (UniCAP system), Df1 and Df2 IgG4 contributed 87% to Df specific IgG4 response, whereas Dp1 and Dp2 contributed 130% to Dp IgG4 response at the 12 months of AIT.
Conclusions
Our findings underscores the importance of major allergens in AIT standardization and design.
All Authors:
Jianjun Chen Yiwen You Yue Zhou Yanjun Wang Weijia Kong
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。