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　　原标题：出生后20年内，IgE对屋尘螨变应原反应性的变化及其预测价值
　　①IgE对屋尘螨中许多过敏原分子的反应性的演化至今还不清楚②我们试图描述从出生到成年过程中IgE对12种屋尘螨分子的应答的演化模式，并研究它们的决定因素和临床相关性。③我们在德国出生队列的多中心过敏研究中对722名参与者的血清和临床资料进行了研究，该研究始于1990年。与螨虫过敏相关的现有的过敏性鼻炎和哮喘的诊断是基于1岁-13岁和1岁-20岁过程中每年一次的随访。在1、2、3、5、6、7、10、13、20岁时，IgE对屋尘螨提取物及12种过敏分子的反应性分别用 ImmunoCAP和微阵列的方法检测，在6个月和18个月时的螨虫暴露，通过检测室内灰尘中的Der p 1重量/重量浓度来评估。④722名参与者中有191名(26.5%)曾有对屋尘螨提取物的IgE(≥0.35 kUA/L)。20岁时，他们的IgE对螨虫组份识别率最高的是Der p 2、Der p1和Der p 23 (A组分子;阳性率为>40%)，其次为Der p5、Der p7、Der p4、Der p21 (B组分子;阳性率15% to 30%）和Der p 11、Der p 18、克隆16、Der p14和Der p15 (C组分子;阳性率< 10%)。IgE敏化几乎总是从A组开始，然后依次扩展到B组，最后扩展到C组。早期IgE敏化开始、父母花粉热和较高的螨暴露与更广泛的多分子IgE敏化模式有关。达到最广泛IgE敏化阶段(即ABC)的参与者患螨虫相关AR和哮喘的风险明显高于未敏化的参与者。5岁或更小的时候IgE对Der p 1或Der p 23的反应性对学龄哮喘有预测价值。⑤父母花粉热和早期的屋尘螨变应原暴露可促进IgE对若干屋尘螨过敏原分子的多重敏化，进而预测当前与屋尘螨相关的AR和当前/未来的哮喘。这些结果可能会对依据IgE敏感性的演化预测和预防螨虫相关AR和哮喘有所启发。
延伸阅读
JACI
Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life
DOI: https://doi.org/10.1016/j.jaci.2016.08.014
Background
The evolution of the IgE response to the numerous allergen molecules of Dermatophagoides pteronyssinus is still unknown.
Objectives
We sought to characterize the evolutionary patterns of the IgE response to 12 molecules of D pteronyssinus from birth to adulthood and to investigate their determinants and clinical relevance.
Methods
We investigated the clinical data and sera of 722 participants in the German Multicenter Allergy Study, a birth cohort started in 1990. Diagnoses of current allergic rhinitis (AR) related to mite allergy and asthma were based on yearly interviews at the ages of 1 to 13 years and 20 years. IgE to the extract and 12 molecules of D pteronyssinus were tested by means of ImmunoCAP and microarray technology, respectively, in sera collected at ages 1, 2, 3, 5, 6, 7, 10, 13, and 20 years. Exposure to mites at age 6 and 18 months was assessed by measuring Der p 1 weight/weight concentration in house dust.
Results
One hundred ninety-one (26.5%) of 722 participants ever had IgE to D pteronyssinus extract (≥0.35 kUA/L). At age 20 years, their IgE recognized most frequently Der p 2, Der p 1, and Der p 23 (group A molecules; prevalence, >40%), followed by Der p 5, Der p 7, Der p 4, and Der p 21 (group B molecules; prevalence, 15% to 30%) and Der p 11, Der p 18, clone 16, Der p 14, and Der p 15 (group C molecules; prevalence, <10%). IgE sensitization started almost invariably with group A molecules and expanded sequentially first to group B and finally to group C molecules. Early IgE sensitization onset, parental hay fever, and higher exposure to mites were associated with a broader polymolecular IgE sensitization pattern. Participants reaching the broadest IgE sensitization stage (ie, ABC) had significantly higher risk of mite-related AR and asthma than unsensitized participants. IgE to Der p 1 or Der p 23 at age 5 years or less predicted asthma at school age.
Conclusions
Parental hay fever and early exposure to D pteronyssinus allergens promote IgE polysensitization to several D pteronyssinus molecules, which in turn predicts current mite-related AR and current/future asthma. These results might inspire predictive algorithms and prevention strategies against the progression of IgE sensitization to mites toward AR and asthma.
All Author:
Daniela Posa Serena Perna Yvonne Resch Christian Lupinek Valentina Panetta Stephanie Hofmaier Alexander Rohrbach Laura Hatzler Linus Grabenhenrich Olympia Tsilochristou Kuan-Wei Chen Carl-Peter Bauer Ute Hoffman Johannes Forster Fred Zepp Antje Schuster Ulrich Wahn Thomas Keil Susanne Lau Susanne Vrtala Rudolf Valenta Paolo Maria Matricardi
　　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。