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背景：过敏原组分检测(CRD)允许识别单分子过敏原组分，并构成了许多过敏单位的常规做法。然而，皮肤点刺试验(SPT)仍然是许多耳鼻喉科的首选技术，但同时也增加了在呼吸道过敏患者中使用不充分的免疫疗法的风险。本研究旨在比较呼吸道过敏患者SPT和CRD测得的致敏谱，探讨致敏与呼吸道疾病类型和严重程度之间的关系。
方法：本研究为因呼吸过敏症状入院的耳鼻喉科患者的横断面、多中心研究。SPT检测不同室内尘螨、花粉和霉菌的提取物，CRD检测其对相应抗原的IgE。
结果：分析包括101名患者。SPT获得的致敏谱与CRD的致敏谱一致性较低，特别是对尘螨和花粉（车前草、油橄榄和柏树）。虽然SPT在致敏和呼吸系统疾病的类型/严重程度之间没有显示出任何显著的关系，但CRD允许将Der p 1，Der f 1和Lep d 2致敏与哮喘以及Der p 2，Der f 2和Lep d 2与更严重的过敏性鼻炎相关联。
结论：与SPT相比，CRD能够描述更准确的致敏谱，并能够识别症状和特异性抗原之间的关联。在耳鼻喉科环境中常规使用CRD可能有助于呼吸过敏患者的管理。
延伸阅读
Clinical and Molecular Allergy 
Sensitization profle inpatients with respiratory allergic diseases: diferences between conventional and molecular diagnosis (a cross‑sectional study)
DOI: org/10.1186/s12948-019-0112-4
Abstract:
Background: Component-resolved diagnosis (CRD) allows to identify single molecular allergen components, and constitutes a routine practice in many allergy units. However, skin prick test (SPT) remains the technique of choice in many otorhinolaryngology departments, thus increasing the risk of using inadequate immunotherapies in patients with respiratory allergies. This study aimed to compare sensitization profles determined by SPT and CRD in patients with respiratory allergy, and to explore the relationship between sensitization and type and severity of the respiratory disease.
Methods: Cross-sectional, multicenter study of patients admitted to the Otorhinolaryngology Department due to symptoms of respiratory allergy. Extracts from various house dust mites, pollens, and molds were tested by SPT, whereas IgE against the corresponding antigens were measured by CRD.
Results: The analysis included 101 patients. The sensitization profle obtained by SPT had low agreement with that of CRD, particularly to dust mite allergens (Dermatophagoides sp.) and pollens (Plantago lanceolata, Olea europaea, and Cupressus sempervirens). While SPT did not show any signifcant relationship between sensitization and type/severity of the respiratory disease, CRD allowed to associate Der p 1, Der f 1 and Lep d 2 sensitizations with asthma, and Der p 2, Der f 2 and Lep d 2 sensitizations with more severe symptoms of allergic rhinitis.
Conclusion: Compared with SPT, CRD enables to describe a more accurate sensitization profle and to identify associations between symptoms and specifc antigens. The routine use of CRD in an otorhinolaryngology setting may beneft the management of patients with respiratory allergy.
First Author:
Guillermo Til—Pérez
Corresponding author
Manuel David TomásBarberán
Correspondence:
Department of Otorhinolaryngology, Hospital Universitario Son Espases, Palma de Mallorca, Spain