过敏原组分解析诊断在过敏疾病中的应用进展
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摘要
免疫球蛋白IgE在Ⅰ型变态反应中起着至关重要的作用。目前,临床上常用的过敏原诊断方法为激发试验和特异性IgE的检测,都依赖于使用过敏原粗提取物。但是,粗提物中不仅含有致敏组分还含有非致敏组分,往往会干扰诊断从而影响后续免疫治疗效果。因此,临床上迫切需要更为准确和稳定的过敏原检测方法。组分解析诊断是一种新的分子诊断技术,它使用纯化的天然或重组过敏原来检测每个过敏组分的特异性IgE水平,避免了粗提物中非致敏组分的干扰,使得检测结果更加准确。另外,此方法还能同时检测多种致敏组分的特异性IgE,极大地提高了检测效率。本文梳理了组分解析诊断在常见过敏性疾病诊断方面的应用,并对其主要研究进展进行系统综述。
IgE antibodies play a key role in type Ⅰ allergic reactions. Currently, the commonly used diagnostic methods of allergens in clinic are provocation test and specific IgE detection, which depend on the use of crude extracts of allergens. However, these crude extracts contain not only allergenic components but also non-allergenic components, which often interfere with the diagnosis and affect the follow-up immunotherapeutic effect. Therefore, more accurate and stable allergen detection methods are urgently needed in clinic. Component-resolved diagnosis is a new molecular diagnostic technique which utilize purified natural or recombinant allergens to detect specific IgE level of each allergic component, avoiding the interference of non-allergic components in crude extracts and making the results more accurate. Moreover, component-resolved diagnosis can simultaneously analyze specific IgE of various sensitizing components at the same time,which greatly improves the detection efficiency. This review summarized recent evidence on the application of component-resolved diagnosis in allergic diseases, and systematically reviews its main research progress.
IgE antibodies play a key role in type Ⅰ allergic reactions. Currently, the commonly used diagnostic methods of allergens in clinic are provocation test and specific IgE detection, which depend on the use of crude extracts of allergens. However, these crude extracts contain not only allergenic components but also non-allergenic components, which often interfere with the diagnosis and affect the follow-up immunotherapeutic effect. Therefore, more accurate and stable allergen detection methods are urgently needed in clinic. Component-resolved diagnosis is a new molecular diagnostic technique which utilize purified natural or recombinant allergens to detect specific IgE level of each allergic component, avoiding the interference of non-allergic components in crude extracts and making the results more accurate. Moreover, component-resolved diagnosis can simultaneously analyze specific IgE of various sensitizing components at the same time,which greatly improves the detection efficiency. This review summarized recent evidence on the application of component-resolved diagnosis in allergic diseases, and systematically reviews its main research progress.
引文
[1] Brunetto B, Tinghino R, Braschi M C, et al. Characterization and comparison of commercially available mite extracts for in vivo diagnosis[J]. Allergy,2010,65(2):184-190.
[2] Hamilton R G,Kleine-Tebbe J. Molecular allergy diagnostics:analytical features that support clinical decisions[J]. Curr Allergy Asthma Rep,2015,15(9):1-7.
[3] Wopfner N, Gruber P,Wallner M,et al. Molecular and immunological characterization of novel weed pollen pan-allergens[J].Allergy,2008,63(7):872-881.
[4] Ebo D G, Hagendorens M M, Bridts C H, et al. Sensitization to cross-reactive carbohydrate determinants and the ubiquitous protein profilin:mimickers of allergy[J]. Clin Exp Allergy,2010,34(1):137-144.
[5] Stringari G,Tripodi S,Caffarelli C, et al. The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever[J]. J Allergy Clin Immunol, 2014,134(1):75-81,e2.
[6] Sander I,Rozynek P,Rihs H P,et al. Multiple wheat flour allergens and cross-reactive carbohydrate determinants bind IgE in baker's asthma[J]. Allergy,2011,66(9):1208-1215.
[7] Gómez-Casado C, Garrido-Arandia M, Pereira C,et al. Component-resolved diagnosis of wheat flour allergy in baker's asthma[J]. J Allergy Clin Immunol,2014,134(2):480-483,e3.
[8] Tay A S L,Shang H S,Bi X Z,et al. Component-resolved diagnosis of house dust mite allergy with a large repertoire of purified natural and recombinant allergens from the major species of mites worldwide[J]. J Allergy Clin Immunol,2005,115(2):S164.
[9] Zeng G,Luo W, Zheng P,et al. Component-resolved diagnostic study of dermatophagoides pteronyssinus major allergen molec.ules in a Southern Chinese cohort[J]. J Investig Allergol Clin Immunol, 2015,25(5):343-351.
[10] Eder K, Becker S,San M N,et al. Usefulness of component resolved analysis of cat allergy in routine clinical practice[J]. Allergy Asthma Clin Immunol,2016,12(1):58.
[11] Basagana M, Luengo O, Labrador M, et al. Component-resolved diagnosis of dog allergy[J]. J Investig Allergol Clin Immunol,2017,27(3):185-187.
[12] Barbosa M C,Santos A B,Ferriani V P,et al. Efficacy of recombinant allergens for diagnosis of cockroach allergy in patients with asthma and/or rhinitis[J]. Int Arch Allergy Immunol, 2013,161(3):213-219.
[13] Peeters K A, Koppelman S J, van Hoffen E, et al. Does skin prick test reactivity to purified allergens correlate with clinical severity of peanut allergy[J]. Clin Exp Allergy,2010,37(1):108-115.
[14] Klemans R J,Van O H,Blankestijn M,et al. Diagnostic accuracy of specific IgE to components in diagnosing peanut allergy:a systematic review[J]. Clin Exp Allergy,2015,45(4):720-730.
[15] Hansen K S, Ballmerweber B K,Sastre J,et al. Component-resolved in vitro diagnosis of hazelnut allergy in Europe[J]. J Allergy Clin Immunol,2009,123(5):1134-1141,e3.
[16] Ebo D G,Bridts C H,Verweij M M,et al. Sensitization profiles in birch pollen-allergic patients with and without oral allergy syndrome to apple:lessons from multiplexed component-resolved allergy diagnosis[J]. Clin Exp Allergy,2010,40(2):339-347.
[17] Bublin M, Pfister M, Radauer C, et al. Component-resolved diagnosis of kiwifruit allergy with purified natural and recombinant kiwifruit allergens[J]. J Allergy Clin Immunol, 2010,125(3):687-694, el.
[18] Jarvinen K M,Beyer K,Vila L,et al. Specificity of IgE antibodies to sequential epitopes of hen's egg ovomucoid as a marker forpersistence of egg allergy[J]. Allergy,2010,62(7):758-765.
[19] Petersen T H,Mortz C G,Bindslev-Jensen C,et al. Cow's milk allergic children-Can component-resolved diagnostics predict duration and severity[J]. Pediatr Allergy Immunol, 2018,29(2):194-199.
[20] Li J, Zhang J, Qiong C, et al. Component resolved diagnostic study of cow's milk allergy in infants and young children in northern China[J].Int Immunopharmacol,2018,61:126-131.
[21] Korosec P,Valenta R,Mittermann I,et al. Low sensitivity of commercially available rApi m 1 for diagnosis of honeybee venom allergy[J]. J Allergy Clin Immunol,2011,128(3):671-673.
[22] Ebo D G,Faber M,Sabato V,et al. Component-resolved diagnosis of wasp(yellow jacket)venom allergy[J]. Clin Exp Allergy,2013,43(2):255-261.
[23] Galindobonilla P A, Galannieto A, Alfayaarias T, et al. Component-resolved diagnosis in vespid venom-allergic individuals[J].Allergol Immunopathol(Madr),2015,43(4):398-402.
[24] Ebo D G, Hagendorens M M, De Knop K J, et al. Component-resolved diagnosis from latex allergy by microarray[J]. Clin Exp Allergy,2010,40(2):348-358.
[25] Ott H, Schroder C, Raulf-Heimsoth M, et al. Microarrays of recombinant Hevea brasiliensis proteins:a novel tool for the component-resolved diagnosis of natural rubber latex allergy[J]. J Investig Allergol Clin Immunol,2010,20(2):129-138.
[2] Hamilton R G,Kleine-Tebbe J. Molecular allergy diagnostics:analytical features that support clinical decisions[J]. Curr Allergy Asthma Rep,2015,15(9):1-7.
[3] Wopfner N, Gruber P,Wallner M,et al. Molecular and immunological characterization of novel weed pollen pan-allergens[J].Allergy,2008,63(7):872-881.
[4] Ebo D G, Hagendorens M M, Bridts C H, et al. Sensitization to cross-reactive carbohydrate determinants and the ubiquitous protein profilin:mimickers of allergy[J]. Clin Exp Allergy,2010,34(1):137-144.
[5] Stringari G,Tripodi S,Caffarelli C, et al. The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever[J]. J Allergy Clin Immunol, 2014,134(1):75-81,e2.
[6] Sander I,Rozynek P,Rihs H P,et al. Multiple wheat flour allergens and cross-reactive carbohydrate determinants bind IgE in baker's asthma[J]. Allergy,2011,66(9):1208-1215.
[7] Gómez-Casado C, Garrido-Arandia M, Pereira C,et al. Component-resolved diagnosis of wheat flour allergy in baker's asthma[J]. J Allergy Clin Immunol,2014,134(2):480-483,e3.
[8] Tay A S L,Shang H S,Bi X Z,et al. Component-resolved diagnosis of house dust mite allergy with a large repertoire of purified natural and recombinant allergens from the major species of mites worldwide[J]. J Allergy Clin Immunol,2005,115(2):S164.
[9] Zeng G,Luo W, Zheng P,et al. Component-resolved diagnostic study of dermatophagoides pteronyssinus major allergen molec.ules in a Southern Chinese cohort[J]. J Investig Allergol Clin Immunol, 2015,25(5):343-351.
[10] Eder K, Becker S,San M N,et al. Usefulness of component resolved analysis of cat allergy in routine clinical practice[J]. Allergy Asthma Clin Immunol,2016,12(1):58.
[11] Basagana M, Luengo O, Labrador M, et al. Component-resolved diagnosis of dog allergy[J]. J Investig Allergol Clin Immunol,2017,27(3):185-187.
[12] Barbosa M C,Santos A B,Ferriani V P,et al. Efficacy of recombinant allergens for diagnosis of cockroach allergy in patients with asthma and/or rhinitis[J]. Int Arch Allergy Immunol, 2013,161(3):213-219.
[13] Peeters K A, Koppelman S J, van Hoffen E, et al. Does skin prick test reactivity to purified allergens correlate with clinical severity of peanut allergy[J]. Clin Exp Allergy,2010,37(1):108-115.
[14] Klemans R J,Van O H,Blankestijn M,et al. Diagnostic accuracy of specific IgE to components in diagnosing peanut allergy:a systematic review[J]. Clin Exp Allergy,2015,45(4):720-730.
[15] Hansen K S, Ballmerweber B K,Sastre J,et al. Component-resolved in vitro diagnosis of hazelnut allergy in Europe[J]. J Allergy Clin Immunol,2009,123(5):1134-1141,e3.
[16] Ebo D G,Bridts C H,Verweij M M,et al. Sensitization profiles in birch pollen-allergic patients with and without oral allergy syndrome to apple:lessons from multiplexed component-resolved allergy diagnosis[J]. Clin Exp Allergy,2010,40(2):339-347.
[17] Bublin M, Pfister M, Radauer C, et al. Component-resolved diagnosis of kiwifruit allergy with purified natural and recombinant kiwifruit allergens[J]. J Allergy Clin Immunol, 2010,125(3):687-694, el.
[18] Jarvinen K M,Beyer K,Vila L,et al. Specificity of IgE antibodies to sequential epitopes of hen's egg ovomucoid as a marker forpersistence of egg allergy[J]. Allergy,2010,62(7):758-765.
[19] Petersen T H,Mortz C G,Bindslev-Jensen C,et al. Cow's milk allergic children-Can component-resolved diagnostics predict duration and severity[J]. Pediatr Allergy Immunol, 2018,29(2):194-199.
[20] Li J, Zhang J, Qiong C, et al. Component resolved diagnostic study of cow's milk allergy in infants and young children in northern China[J].Int Immunopharmacol,2018,61:126-131.
[21] Korosec P,Valenta R,Mittermann I,et al. Low sensitivity of commercially available rApi m 1 for diagnosis of honeybee venom allergy[J]. J Allergy Clin Immunol,2011,128(3):671-673.
[22] Ebo D G,Faber M,Sabato V,et al. Component-resolved diagnosis of wasp(yellow jacket)venom allergy[J]. Clin Exp Allergy,2013,43(2):255-261.
[23] Galindobonilla P A, Galannieto A, Alfayaarias T, et al. Component-resolved diagnosis in vespid venom-allergic individuals[J].Allergol Immunopathol(Madr),2015,43(4):398-402.
[24] Ebo D G, Hagendorens M M, De Knop K J, et al. Component-resolved diagnosis from latex allergy by microarray[J]. Clin Exp Allergy,2010,40(2):348-358.
[25] Ott H, Schroder C, Raulf-Heimsoth M, et al. Microarrays of recombinant Hevea brasiliensis proteins:a novel tool for the component-resolved diagnosis of natural rubber latex allergy[J]. J Investig Allergol Clin Immunol,2010,20(2):129-138.