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原标题：花生组分在IgE介导的花生过敏的不同人群中的诊断作用
　　①背景越来越多的数据表明，对花生组分特异性IgE的分析对花生过敏的临床诊断有一定的帮助，可能比全花生特异性IgE的分析更为准确。然而，并不是所有研究都使用了前瞻性样本、多种组分和花生激发试验。②目的 我们试图确定花生组分特异性IgE检测在花生过敏诊断上的作用，使用一个标准化的商业化试剂盒，在口服花生激发试验之前，对来自两个不同国家不同人群的疑似花生过敏患者进行了检测。③方法 对来自两个国家的4个不同队列过敏患者的血清，在双盲安慰剂激发试验前进行全花生提取物特异性IgE和花生组分Ara h 1, 2, 3, 8 特异性IgE检测。④结果 对患者(n = 167，中位年龄11.7岁，四分位差范围7-15）血清进行全花生及花生组分特异性IgE分析，并完成对花生的口服食物激发试验。花生IgE敏感性最高(0.93)，Ara h 2特异性最高(0.92)且阳性预测值最高(0.94)。通过ROC分析(曲线下面积，0.84;P < . 05)显示，Ara h 2的诊断价值最好。⑤结论 在疑似花生过敏的患者中，全花生特异性IgE敏感较好，但特异性不足。在本次抽样的疑似花生过敏患者中，Ara h 2特异性IgE检测是一种特异更好、更准确的诊断性检测。鉴于每次检测不同的情况，引入组分检测可以为临床医生提供一种过敏性疾病诊断的新方法，尽量减少花生激发试验的应用。
延伸阅读
JACI
The Utility of Peanut Components in the Diagnosis of IgE-Mediated Peanut Allergy Among Distinct Populations
https://doi.org/10.1016/j.jaip.2012.11.002
Background
Increasing data suggest that analysis of IgE to peanut components can be clinically helpful and possibly more accurate than IgE to whole peanut. Not all studies examining this topic, however, have used prospective samples, multiple components, and peanut challenges.
Objective
We sought to determine the utility of peanut component testing, using a standardized, commercially available test done before oral peanut challenge in various populations of patients with suspected peanut allergy from 2 different countries.
Methods
IgE to whole peanut and the recombinant allergen components Ara h 1, 2, 3, and 8 were analyzed from serum samples drawn before double-blind peanut challenge from 4 distinct cohorts of patients with suspected peanut allergy from 2 nations (United States and Sweden).
Results
Patients (n = 167; median age, 11.7 years; interquartile range, 7.0-15.0 years) had serum analyzed for peanut components and completed an oral food challenge to peanut. Although IgE to peanut was the most sensitive test (0.93), Ara h 2 was the most specific (0.92) and provided the best positive predictive value (0.94) of all the tests. Ara h 2 was also the best overall diagnostic test by receiver operating characteristic analysis (area under the curve, 0.84; P < .05).
Conclusions
In patients with suspected peanut allergy, IgE to peanut is a sensitive test but is not specific. IgE to Ara h 2 is a more specific and more accurate diagnostic test in this sampling of patients with suspected peanut allergy. Given each tests attributes, a stepwise approach to testing may provide clinicians with a way to minimize the need for peanut challenges.
All Author:
A.LiebermanMDa∗SusanneGlaumannMDbcSofiaBatelsonMDcMagnus P.BorresMD, PhDdeHugh A.SampsonMDaCarolineNilssonMD, PhDbc
　　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。