杭州浙大迪迅生物基因工程有限公司

背景：屋尘螨（HDM）是一种重要的吸入性过敏原，与特应性疾病高度相关。常规过敏原组分检测一般仅包含32种登记命名的户尘螨组分中的4种。许多组分与临床相关性和病理学尚不清楚。
目的：旨在探究几种HDM组分与过敏性鼻炎、过敏性哮喘和特应性皮炎的相关性，以确定具有生物标记物潜力的过敏原，并将其转移到诊断中。
方法：重组表达并纯化了9种户尘螨组分中的8种（nDer p 1、rDer p 2、rDer p 5、rDer p 7、rDer p 10、rDer p 13、rDer p 20、rDer p 21、rDer p 23）。用多重阵列分析了384名表现出不同临床表型的HDM过敏个体的致敏模式。
结果：对三种以上的尘螨组分（致敏计数）的致敏与过敏性哮喘和/或特应性皮炎相关。与过敏性鼻炎相比，过敏性哮喘患者对Der p 5和Der p 21的反应更频繁。特应性皮炎患者更常对Der p 5、Der p 20和Der p 21等过敏。在75%的患者中，Der p 20 IgE>80 kU/L与严重特应性皮炎相关。
结论：本研究证明了致敏计数和某些过敏原（Der p 5、Der p 20和Der p 21）的临床重要性，这些过敏原尚未用于常规诊断。检测这些项目以及考虑诊断中的致敏计数将提高HDM过敏患者的诊断和风险评估。



延伸阅读
Allergy
Specific IgE against the house dust mite allergens Der p 5, 20 and 21 influences the phenotype and severity of atopic diseases
DOI: 10.1111/all.15553
Abstract:
Background: House dust mites (HDM) are among the most important sources for airborne allergens with high relevance for atopic diseases. Routine tests contain only 4 of 32 registered allergens of Dermatophagoides pteronyssinus. Clinical relevance and pathomechanistic properties of many allergens are not well understood.
Objective: The association of several HDM allergens with allergic rhinitis, allergic asthma, and atopic dermatitis was investigated to identify allergens with biomarker potential and to transfer them into diagnostics.
Methods: Eight out of nine D. pteronyssinus allergens (nDer p 1, rDer p 2, rDer p 5, rDer p 7, rDer p 10, rDer p 13, rDer p 20, rDer p 21, rDer p 23) were recombinantly expressed and purified. Sensitization patterns of 384 HDM-allergic individuals exhibiting different clinical phenotypes were analyzed with a serum-saving multiplex array.
Results: Sensitization to more than three mite allergens (sensitization count) was associated with allergic asthma and/or atopic dermatitis. Reactions to Der p 5 and Der p 21 were more frequent in allergic asthma compared to allergic rhinitis. Atopic dermatitis patients were more often sensitized to Der p 5, Der p 20, and Der p 21 among others. Der p 20-IgE> 80 kU/L was associated with severe atopic dermatitis in 75% of patients.
Conclusion: This study demonstrates the clinical importance of the sensitization count and of certain allergens (Der p 5, Der p 20, and Der p 21) not available for routine diagnostics yet. Implementing them as well as the sensitization count in diagnostic measures will improve diagnosis and risk assessment of HDM-allergic patients.
First Author:
Theresa Walsemann
Corresponding author
Uta Jappe
Correspondence:
Uta Jappe, Division of Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Parkallee 35,23845 Borstel, Germany.