杭州浙大迪迅生物基因工程有限公司

背景：过敏原组分检测（CRD）可以帮助建立免疫球蛋白E（IgE）致敏谱和潜在风险，并确定特异性IgE是主要致敏还是交叉反应性的结果，特别是对于那些多重致敏的患者。
方法：我们招募了432名尘螨致敏的呼吸道过敏性疾病患者，采用CRD检测研究了中国广东省17种过敏原组分的致敏性和交叉反应性，并描述过敏原组分之间的潜在关联。
结果：在432例患者中， 17种组分血清特异性IgE中Der p 1（81.48%）、Der f 2（77.78%）、Der f 1（74.07%）、Der p 2（66.20%）和Der p 23（54.63%）是尘螨致敏呼吸道过敏患者的主要致敏组分，而蟑螂、蟹、虾的阳性率较低。粗提物过敏原阳性的样品中，Der f 2（91.06%）和Der f 1（86.72%）为Der f的主要致敏成分，Der p 1（94.52%）、Der p 2（78.36%）、Der p 23（63.29%）为Der p的主要致敏成分，而Der p 7（34.25%）、Der p 5（17.81%）、Der p 10（12.05%）、Der p 3（1.92%）均低于50.00%。Blo t 5（54.55%）是Blo t的主要组成部分之一。所有Bla g成分的阳性率分别为：rBla g 2（15.56%）>rBla g 5（8.89%）>rBla  g4（4.44%）>rBla g 1（1.11%）。唯一可用的Pen a 1组分的阳性率为9.43%。通过分层聚类和最优尺度分析，将17个组分大致划分为5个不同的致敏聚类。此外，从维恩图的结果来看，每个类群中的过敏原组分都有很高的共敏性和交叉反应的比例。无论年龄、总IgE水平和疾病类型因素如何，基于层次聚类分析，我们观察到同一类别中的每个组分有相似的致敏谱。Cypress 发挥的作用有限，只有 1/22 SPT 单一致敏患者报告食物反应（p < 0.073）。
结论：使用CRD可以进一步了解引起过敏症状的过敏原组分的流行病学数据。Der p1、Der p 2、Der p 23、Der f 1、Der f 2为研究队列的主要致敏组分。Blo t 5在所有人群中的阳性率为28.01%，Blo t阳性样本的CRD阳性率为54.45%。此外，CRD允许我们识别更多潜在的过敏原关联，如共同的敏感性和组分蛋白之间的交叉反应。基于这些结果，我们建议，当患者被确定为对特定的过敏原敏感时，临床医生可以更多地关注与之密切相关的其他过敏物质。



延伸阅读
Int Arch Allergy Immunol
Identifying Potential Co-Sensitization and Cross-Reactivity Patterns Based on Component-Resolved Diagnosis
DOI: 10.1159/000504320
Abstract:
Background: Component-Resolved diagnosis (CRD) can help to establish immunoglobulin E (IgE) sensitization profiles and potential risks and determines whether specific IgE is the result of primary sensitization or cross-reactivity, especially for those who are polysensitized.
Methods: We recruited 432 patients with mite-sensitized respiratory allergic diseases to study the co-sensitization and cross-reactivity of the 17 allergen components in Guangdong Province, China, using the CRD method and to describe the potential association between allergen components.
Results: Among the 432 patients, serum specific immunoglobulin E of the 17 components. Der p 1 (81.48%), Der f 2 (77.78%), Der f 1 (74.07%), Der p 2 (66.20%) and Der p 23 (54.63%) were the main sensitized components in patients with mite-sensitized respiratory allergy, while the   components of cockroach, crab, and shrimp had a lower positive rate. In the crude extract allergen-positive samples, Der f 2 (91.06%) and Der f 1 (86.72%) were the major sensitized components of Der f, while Der p 1 (94.52%), Der p 2 (78.36%), Der p 23 (63.29%) were the major sensitized components of Der p, and other components of Der p such as Der p 7 (34.25%), Der p 5 (17.81%), Der p 10 (12.05%), Der p 3 (1.92%) were all below 50.00%. Blo t 5 (54.55%) was one of the major components of Blo t. The positive rates of all Bla g components were as follows, rBla g 2 (15.56%) >rBla g 5 (8.89%) >rBla g 4 (4.44%) >rBla g 1 (1.11%). The positive rate of the only available pen a 1 component was 9.43%. Using hierarchical cluster and optimal scale analysis, 17 components can be roughly divided into 5 different sensitization clusters. Also, from the results of the Venn diagram, the allergen component in each cluster has a high proportion of co-sensitization and cross-reactivity. Regardless of age, total IgE levels, and disease type factors, similar sensitization profiles were observed for each component in the same category based on hierarchical clustering analysis.
Conclusion: Epidemiological data on allergen components causing allergic symptoms can be further understood using CRD. Der p 1, Der p 2, Der p 23, Der f 1, Der f 2 as the primary sensitizing component of the study cohort. The positive rate for Blo t 5 was 28.01% for all populations and 54.45% for Blo t-positive samples. In addition, CRD allows us to identify more potential allergen associations such as common sensitivities and cross-reactions between component proteins. Based on these results, we suggest that when patients are identified as sensitized to a particular allergen, clinicians can pay more attention to other allergy components that are closely related to it.
First Author:
Zhifeng Huang
Corresponding author
Baoqing Sun
Correspondence:
Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University 151 Yan Jiang Road, Guangzhou, Guangdong 510120 (China)